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44D1013777 CLIA NUMBER - KROGER PHARMACY 25-481

Laboratory Demographics

CLIA Number: 44D1013777

Facility Name: KROGER PHARMACY 25-481

Facility Address:
3685 HOUSTON LEVEE ROAD ATTN PHARMACY
COLLIERVILLE, TN
ZIP 38017
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Facility Phone Number: 901 854-2707

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1093730715

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 44D1013777
LAB Type Pharmacy
Facility Name KROGER PHARMACY 25-481
Street 3685 HOUSTON LEVEE ROAD ATTN PHARMACY
City COLLIERVILLE
State TN
ZIP 38017
Phone 901 854-2707
CertificateType 4
CertificateEffectiveDate 6/17/2023
CertificateExpirationDate 6/16/2025
FacilityType Waiver

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