36D2095042 CLIA NUMBER - KROGER PHARMACY #831

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Laboratory Demographics

CLIA Number: 36D2095042

Facility Name: KROGER PHARMACY #831

Facility Address:
19471 LAKE DR
TRIMBLE, OH
ZIP 45782
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Facility Phone Number: 740 767-3851

Facility Type: Other - PHARMACY

Certificate Type: Waiver

NPI Number: 1730268228

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	36D2095042
LAB Type	Other - PHARMACY
Facility Name	KROGER PHARMACY #831
Street	19471 LAKE DR
City	TRIMBLE
State	OH
ZIP	45782
Phone	740 767-3851
CertificateType	4
CertificateEffectiveDate	4/29/2023
CertificateExpirationDate	4/28/2025
FacilityType	Waiver

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