49D1002081 CLIA NUMBER - KROGER PHARMACY

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Laboratory Demographics

CLIA Number: 49D1002081

Facility Name: KROGER PHARMACY

Facility Address:
4816 S LABURNUM AVENUE
RICHMOND, VA
ZIP 23294
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Facility Phone Number: 804 226-0010

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1780618553

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	49D1002081
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY
Street	4816 S LABURNUM AVENUE
City	RICHMOND
State	VA
ZIP	23294
Phone	804 226-0010
CertificateType	4
CertificateEffectiveDate	7/29/2022
CertificateExpirationDate	7/28/2024
FacilityType	Waiver

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