49D2003746 CLIA NUMBER - KROGER PHARMACY - 322

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Laboratory Demographics

CLIA Number: 49D2003746

Facility Name: KROGER PHARMACY - 322

Facility Address:
915 HARDY ROAD LAKE DRIVE PLAZA
VINTON, VA
ZIP 24179
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Facility Phone Number: 540 344-1215

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1851325591

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	49D2003746
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY - 322
Street	915 HARDY ROAD LAKE DRIVE PLAZA
City	VINTON
State	VA
ZIP	24179
Phone	540 344-1215
CertificateType	4
CertificateEffectiveDate	2/17/2024
CertificateExpirationDate	2/16/2026
FacilityType	Waiver

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