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45D1082377 CLIA NUMBER - KROGER PHARMACY 581

Laboratory Demographics

CLIA Number: 45D1082377

Facility Name: KROGER PHARMACY 581

Facility Address:
2925 CUSTER ROAD
PLANO, TX
ZIP 75075
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Facility Phone Number: 972 612-1864

Facility Type: Industrial

Certificate Type: Waiver
NPI Number: 1861565384

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 45D1082377
LAB Type Industrial
Facility Name KROGER PHARMACY 581
Street 2925 CUSTER ROAD
City PLANO
State TX
ZIP 75075
Phone 972 612-1864
CertificateType 4
CertificateEffectiveDate 4/8/2024
CertificateExpirationDate 4/7/2026
FacilityType Waiver

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