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49D1093846 CLIA NUMBER - KROGER PHARMACY # 391

Laboratory Demographics

CLIA Number: 49D1093846

Facility Name: KROGER PHARMACY # 391

Facility Address:
3970 VALLEY GATEWAY BOULEVARD
ROANOKE, VA
ZIP 24012
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Facility Phone Number: 540 977-6481

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1275558975

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 49D1093846
LAB Type Pharmacy
Facility Name KROGER PHARMACY # 391
Street 3970 VALLEY GATEWAY BOULEVARD
City ROANOKE
State VA
ZIP 24012
Phone 540 977-6481
CertificateType 4
CertificateEffectiveDate 1/5/2023
CertificateExpirationDate 1/4/2025
FacilityType Waiver

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