04D1021891 CLIA NUMBER - KROGER PHARMACY 619

Laboratory Demographics

  • CLIA Code: 04D1021891
  • Facility Name: KROGER PHARMACY 619
  • Facility Address: 215 AIRPORT ROAD
    HOT SPRINGS, AR
    ZIP 71901
  • Facility Phone: 501 623-2650
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CYNTHIA B. FISHER
  • NPI Number: 1386669083
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D1021891
LAB Type Pharmacy
Facility Name KROGER PHARMACY 619
Street 215 AIRPORT ROAD
City HOT SPRINGS
State AR
ZIP 71901
Phone 501 623-2650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Pharmacy
Lab Director CYNTHIA B. FISHER

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