36D2038836 CLIA NUMBER - KROGER PHARMACY #833

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Laboratory Demographics

CLIA Number: 36D2038836

Facility Name: KROGER PHARMACY #833

Facility Address:
200 LEASE AVENUE
GREENVILLE, OH
ZIP 45331
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Facility Phone Number: 937 548-1736

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1134153844

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	36D2038836
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY #833
Street	200 LEASE AVENUE
City	GREENVILLE
State	OH
ZIP	45331
Phone	937 548-1736
CertificateType	4
CertificateEffectiveDate	3/27/2024
CertificateExpirationDate	3/26/2026
FacilityType	Waiver

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