44D2000938 CLIA NUMBER - KROGER PHARMACY L-893

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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