23D1101953 CLIA NUMBER - KROGER PHARMACY

Home > CLIA Lookup > 23D1101953

Laboratory Demographics

CLIA Number: 23D1101953

Facility Name: KROGER PHARMACY

Facility Address:
47060 PONTIAC TRAIL KROGER PHARMACY 018-634 ATTN PHARMACIST IN CHARGE
WALLED LAKE, MI
ZIP 48390
Get Directions

Facility Phone Number: 248 960-8297

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1164456927

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	23D1101953
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY
Street	47060 PONTIAC TRAIL KROGER PHARMACY 018-634 ATTN PHARMACIST IN CHARGE
City	WALLED LAKE
State	MI
ZIP	48390
Phone	248 960-8297
CertificateType	4
CertificateEffectiveDate	7/8/2023
CertificateExpirationDate	7/7/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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