04D1021916 CLIA NUMBER - KROGER PHARMACY 590

Laboratory Demographics

  • CLIA Code: 04D1021916
  • Facility Name: KROGER PHARMACY 590
  • Facility Address: 3341 CENTRAL AVENUE
    HOT SPRINGS, AR
    ZIP 71901
  • Facility Phone: 501 624-5542
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CYNTHIA B. FISHER
  • NPI Number: 1427082270
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 04D1021916
LAB Type Pharmacy
Facility Name KROGER PHARMACY 590
Street 3341 CENTRAL AVENUE
City HOT SPRINGS
State AR
ZIP 71901
Phone 501 624-5542
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