23D2077123 CLIA NUMBER - KROGER CO OF MICHIGAN, THE

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Laboratory Demographics

CLIA Number: 23D2077123

Facility Name: KROGER CO OF MICHIGAN, THE

Facility Address:
17447 HAGGERTY KROGER PHARMACY 018-442 ATTN PHARMACIST IN CHARGE
NORTHVILLE, MI
ZIP 48167
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Facility Phone Number: 248 662-3032

Facility Type: Other - RETAIL PHARMACY

Certificate Type: Waiver

NPI Number: 1386844397

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	23D2077123
LAB Type	Other - RETAIL PHARMACY
Facility Name	KROGER CO OF MICHIGAN, THE
Street	17447 HAGGERTY KROGER PHARMACY 018-442 ATTN PHARMACIST IN CHARGE
City	NORTHVILLE
State	MI
ZIP	48167
Phone	248 662-3032
CertificateType	4
CertificateEffectiveDate	5/1/2022
CertificateExpirationDate	4/30/2024
FacilityType	Waiver

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