23D2077091 CLIA NUMBER - KROGER CO OF MICHIGAN, THE

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Laboratory Demographics

CLIA Number: 23D2077091

Facility Name: KROGER CO OF MICHIGAN, THE

Facility Address:
531 W MAIN STREET KROGER PHARMACY 018-576 ATTN PHARMACIST IN CHARGE
MILAN, MI
ZIP 48160
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Facility Phone Number: 734 439-6856

Facility Type: Other - RETAIL PHARMACY

Certificate Type: Waiver

NPI Number: 1922032796

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	23D2077091
LAB Type	Other - RETAIL PHARMACY
Facility Name	KROGER CO OF MICHIGAN, THE
Street	531 W MAIN STREET KROGER PHARMACY 018-576 ATTN PHARMACIST IN CHARGE
City	MILAN
State	MI
ZIP	48160
Phone	734 439-6856
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