36D2021121 CLIA NUMBER - KROGER PHARMACY #522

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Laboratory Demographics

CLIA Number: 36D2021121

Facility Name: KROGER PHARMACY #522

Facility Address:
300 SOUTH HAMILTON ROAD
GAHANNA, OH
ZIP 43230
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Facility Phone Number: 614 416-6420

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1306861018

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	36D2021121
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY #522
Street	300 SOUTH HAMILTON ROAD
City	GAHANNA
State	OH
ZIP	43230
Phone	614 416-6420
CertificateType	4
CertificateEffectiveDate	3/7/2023
CertificateExpirationDate	3/6/2025
FacilityType	Waiver

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