36D2112419 CLIA NUMBER - KROGER PHARMACY

Laboratory Demographics

CLIA Number: 36D2112419

Facility Name: KROGER PHARMACY

Facility Address:
1428 MARION WALDO RD
MARION, OH
ZIP 43302
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Facility Phone Number: 740 386-2321

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1558395251

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	36D2112419
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY
Street	1428 MARION WALDO RD
City	MARION
State	OH
ZIP	43302
Phone	740 386-2321
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