01D2084055 CLIA NUMBER - KROGER PHARMACY #517

Laboratory Demographics

  • CLIA Code: 01D2084055
  • Facility Name: KROGER PHARMACY #517
  • Facility Address: 6070 MOORES MILL ROAD
    HUNTSVILLE, AL
    ZIP 35811
  • Facility Phone: 256 852-4267
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEREMY CRAIN
  • NPI Number: 1245264084
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2084055
LAB Type Pharmacy
Facility Name KROGER PHARMACY #517
Street 6070 MOORES MILL ROAD
City HUNTSVILLE
State AL
ZIP 35811
Phone 256 852-4267
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Pharmacy
Lab Director JEREMY CRAIN

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This page was last updated on: 9/29/2025