23D2077076 CLIA NUMBER - KROGER CO OF MICHIGAN, THE

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Laboratory Demographics

CLIA Number: 23D2077076

Facility Name: KROGER CO OF MICHIGAN, THE

Facility Address:
2010 WHITTAKER ROAD KROGER PHARMACY 018-707 ATTN PHARMACIST IN CHARGE
YPSILANTI, MI
ZIP 48197
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Facility Phone Number: 734 547-1847

Facility Type: Other - RETAIL PHARMAMCY

Certificate Type: Waiver

NPI Number: 1346265048

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	23D2077076
LAB Type	Other - RETAIL PHARMAMCY
Facility Name	KROGER CO OF MICHIGAN, THE
Street	2010 WHITTAKER ROAD KROGER PHARMACY 018-707 ATTN PHARMACIST IN CHARGE
City	YPSILANTI
State	MI
ZIP	48197
Phone	734 547-1847
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