49D2098295 CLIA NUMBER - KROGER PHARMACY #517

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Laboratory Demographics

CLIA Number: 49D2098295

Facility Name: KROGER PHARMACY #517

Facility Address:
11895 WEST BROAD STREET
RICHMOND, VA
ZIP 23233
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Facility Phone Number: 804 360-3268

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1508890385

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	49D2098295
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY #517
Street	11895 WEST BROAD STREET
City	RICHMOND
State	VA
ZIP	23233
Phone	804 360-3268
CertificateType	4
CertificateEffectiveDate	3/1/2024
CertificateExpirationDate	2/28/2026
FacilityType	Waiver

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