44D2000938 CLIA NUMBER - KROGER PHARMACY L-893

Laboratory Demographics

CLIA Number: 44D2000938

Facility Name: KROGER PHARMACY L-893

Facility Address:
445 S JEFFERSON AVE ATTN PHARMACY
COOKEVILLE, TN
ZIP 38501
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Facility Phone Number: 931 528-8011

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1568496297

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 44D2000938
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-893
Street 445 S JEFFERSON AVE ATTN PHARMACY
City COOKEVILLE
State TN
ZIP 38501
Phone 931 528-8011
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