45D1067429 CLIA NUMBER - KROGER PHARMACY 264

Laboratory Demographics

CLIA Number: 45D1067429

Facility Name: KROGER PHARMACY 264

Facility Address:
3245 EAST BROADWAY (FM 518)
PEARLAND, TX
ZIP 77581
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Facility Phone Number: 281 485-1323

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1528131141

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	45D1067429
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY 264
Street	3245 EAST BROADWAY (FM 518)
City	PEARLAND
State	TX
ZIP	77581
Phone	281 485-1323
CertificateType	4
CertificateEffectiveDate	4/18/2023
CertificateExpirationDate	4/17/2025
FacilityType	Waiver

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