36D2009106 CLIA NUMBER - KROGER PHARMACY #519

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Laboratory Demographics

CLIA Number: 36D2009106

Facility Name: KROGER PHARMACY #519

Facility Address:
1585 GEORGESVILLE SQUARE DRIVE
COLUMBUS, OH
ZIP 43228
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Facility Phone Number: 614 878-1664

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1649715491

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	36D2009106
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY #519
Street	1585 GEORGESVILLE SQUARE DRIVE
City	COLUMBUS
State	OH
ZIP	43228
Phone	614 878-1664
CertificateType	4
CertificateEffectiveDate	6/25/2022
CertificateExpirationDate	6/24/2024
FacilityType	Waiver

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