23D2077079 CLIA NUMBER - KROGER CO OF MICHIGAN, THE

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Laboratory Demographics

CLIA Number: 23D2077079

Facility Name: KROGER CO OF MICHIGAN, THE

Facility Address:
26130 GRATIOT KROGER PHARMACY 018-663 ATTN PHARMACIST IN CHARGE
ROSEVILLE, MI
ZIP 48066
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Facility Phone Number: 586 776-8583

Facility Type: Other - RETAIL PHARMACY

Certificate Type: Waiver

NPI Number: 1013386986

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	23D2077079
LAB Type	Other - RETAIL PHARMACY
Facility Name	KROGER CO OF MICHIGAN, THE
Street	26130 GRATIOT KROGER PHARMACY 018-663 ATTN PHARMACIST IN CHARGE
City	ROSEVILLE
State	MI
ZIP	48066
Phone	586 776-8583
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