36D2112415 CLIA NUMBER - KROGER PHARMACY

Laboratory Demographics

CLIA Number: 36D2112415

Facility Name: KROGER PHARMACY

Facility Address:
3675 E BROAD STREET
WHITEHALL, OH
ZIP 43213
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Facility Phone Number: 614 239-0404

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1669406369

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	36D2112415
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY
Street	3675 E BROAD STREET
City	WHITEHALL
State	OH
ZIP	43213
Phone	614 239-0404
CertificateType	4
CertificateEffectiveDate	4/28/2024
CertificateExpirationDate	4/27/2026
FacilityType	Waiver

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