18D2000589 CLIA NUMBER - KROGER PHARMACY 729

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Laboratory Demographics

CLIA Number: 18D2000589

Facility Name: KROGER PHARMACY 729

Facility Address:
3616 BUECHEL BYPASS
LOUISVILLE, KY
ZIP 40218
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Facility Phone Number: 502 458-9511

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1487688206

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	18D2000589
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY 729
Street	3616 BUECHEL BYPASS
City	LOUISVILLE
State	KY
ZIP	40218
Phone	502 458-9511
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