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36D1090091 CLIA NUMBER - KROGER PHARMACY 014-907

Laboratory Demographics

CLIA Number: 36D1090091

Facility Name: KROGER PHARMACY 014-907

Facility Address:
10477 HARRISON AVENUE
HARRISON, OH
ZIP 45030
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Facility Phone Number: 513 367-2382

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1124052923

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 36D1090091
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-907
Street 10477 HARRISON AVENUE
City HARRISON
State OH
ZIP 45030
Phone 513 367-2382
CertificateType 4
CertificateEffectiveDate 10/2/2022
CertificateExpirationDate 10/1/2024
FacilityType Waiver

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