36D2113913 CLIA NUMBER - KROGER PHARMACY #990

Laboratory Demographics

CLIA Number: 36D2113913

Facility Name: KROGER PHARMACY #990

Facility Address:
2161 EAKIN RD
COLUMBUS, OH
ZIP 43223
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Facility Phone Number: 614 274-7748

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1164456968

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	36D2113913
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY #990
Street	2161 EAKIN RD
City	COLUMBUS
State	OH
ZIP	43223
Phone	614 274-7748
CertificateType	4
CertificateEffectiveDate	6/2/2022
CertificateExpirationDate	6/1/2024
FacilityType	Waiver

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