23D2076981 CLIA NUMBER - KROGER CO OF MICHIGAN, THE

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Laboratory Demographics

CLIA Number: 23D2076981

Facility Name: KROGER CO OF MICHIGAN, THE

Facility Address:
108 W HIGHLAND KROGER PHARMACY 018-720 ATTN PHARMACIST IN CHARGE
HOWELL, MI
ZIP 48843
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Facility Phone Number: 517 552-0205

Facility Type: Other - RETAIL PHARMACY

Certificate Type: Waiver

NPI Number: 1306870142

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	23D2076981
LAB Type	Other - RETAIL PHARMACY
Facility Name	KROGER CO OF MICHIGAN, THE
Street	108 W HIGHLAND KROGER PHARMACY 018-720 ATTN PHARMACIST IN CHARGE
City	HOWELL
State	MI
ZIP	48843
Phone	517 552-0205
CertificateType	4
CertificateEffectiveDate	4/30/2024
CertificateExpirationDate	4/29/2026
FacilityType	Waiver

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