44D2000926 CLIA NUMBER - KROGER PHARMACY L-594

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Laboratory Demographics

CLIA Number: 44D2000926

Facility Name: KROGER PHARMACY L-594

Facility Address:
4900 PORT ROYAL RD ATTN PHARMACY
SPRING HILL, TN
ZIP 37174
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Facility Phone Number: 931 560-2142

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1871747113

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	44D2000926
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY L-594
Street	4900 PORT ROYAL RD ATTN PHARMACY
City	SPRING HILL
State	TN
ZIP	37174
Phone	931 560-2142
CertificateType	4
CertificateEffectiveDate	12/9/2023
CertificateExpirationDate	12/8/2025
FacilityType	Waiver

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