36D2040124 CLIA NUMBER - KROGER PHARMACY #895

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Laboratory Demographics

CLIA Number: 36D2040124

Facility Name: KROGER PHARMACY #895

Facility Address:
7545 SYLVANIA AVENUE
SYLVANIA, OH
ZIP 43560
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Facility Phone Number: 419 841-6468

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1639194343

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	36D2040124
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY #895
Street	7545 SYLVANIA AVENUE
City	SYLVANIA
State	OH
ZIP	43560
Phone	419 841-6468
CertificateType	4
CertificateEffectiveDate	4/24/2024
CertificateExpirationDate	4/23/2026
FacilityType	Waiver

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