Healther Providers Data Logo

36D1013349 CLIA NUMBER - KROGER PHARMACY 014-817

Laboratory Demographics

CLIA Number: 36D1013349

Facility Name: KROGER PHARMACY 014-817

Facility Address:
1230 ROMBACH AVE
WILMINGTON, OH
ZIP 45177
Get Directions

Facility Phone Number: 937 655-5720

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1922032622

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 36D1013349
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-817
Street 1230 ROMBACH AVE
City WILMINGTON
State OH
ZIP 45177
Phone 937 655-5720
CertificateType 4
CertificateEffectiveDate 10/2/2022
CertificateExpirationDate 10/1/2024
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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