18D2000579 CLIA NUMBER - KROGER PHARMACY L-713

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Laboratory Demographics

CLIA Number: 18D2000579

Facility Name: KROGER PHARMACY L-713

Facility Address:
995 SOUTH MAIN STREET
NICHOLASVILLE, KY
ZIP 40356
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Facility Phone Number: 859 881-9086

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1336173152

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	18D2000579
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY L-713
Street	995 SOUTH MAIN STREET
City	NICHOLASVILLE
State	KY
ZIP	40356
Phone	859 881-9086
CertificateType	4
CertificateEffectiveDate	12/3/2023
CertificateExpirationDate	12/2/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024