04D1021915 CLIA NUMBER - KROGER PHARMACY 627

Laboratory Demographics

  • CLIA Code: 04D1021915
  • Facility Name: KROGER PHARMACY 627
  • Facility Address: 8824 GEYER SPRINGS ROAD
    LITTLE ROCK, AR
    ZIP 72209
  • Facility Phone: 501 565-7584
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CYNTHIA B. FISHER
  • NPI Number: 1972537710
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D1021915
LAB Type Pharmacy
Facility Name KROGER PHARMACY 627
Street 8824 GEYER SPRINGS ROAD
City LITTLE ROCK
State AR
ZIP 72209
Phone 501 565-7584
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