45D2136168 CLIA NUMBER - KROGER PHARMACY #596

Laboratory Demographics

CLIA Number: 45D2136168

Facility Name: KROGER PHARMACY #596

Facility Address:
2200 FM 663
MIDLOTHIAN, TX
ZIP 76065
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Facility Phone Number: 469 336-2041

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1730601782

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	45D2136168
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY #596
Street	2200 FM 663
City	MIDLOTHIAN
State	TX
ZIP	76065
Phone	469 336-2041
CertificateType	4
CertificateEffectiveDate	9/5/2023
CertificateExpirationDate	9/4/2025
FacilityType	Waiver

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