36D2059813 CLIA NUMBER - KROGER PHARMACY #621

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Laboratory Demographics

CLIA Number: 36D2059813

Facility Name: KROGER PHARMACY #621

Facility Address:
600 E MAIN ST
HEBRON, OH
ZIP 43025
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Facility Phone Number: 740 928-2152

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1679507396

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	36D2059813
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY #621
Street	600 E MAIN ST
City	HEBRON
State	OH
ZIP	43025
Phone	740 928-2152
CertificateType	4
CertificateEffectiveDate	5/31/2023
CertificateExpirationDate	5/30/2025
FacilityType	Waiver

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