15D2001074 CLIA NUMBER - KROGER PHARMACY #744

Laboratory Demographics

  • CLIA Code: 15D2001074
  • Facility Name: KROGER PHARMACY #744
  • Facility Address: 2864 CHARLESTOWN RD
    NEW ALBANY, IN
    ZIP 47150
  • Facility Phone: 812 948-0953
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PHELICISIMA ROBERTS
  • NPI Number: 1811912694
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2001074
LAB Type Pharmacy
Facility Name KROGER PHARMACY #744
Street 2864 CHARLESTOWN RD
City NEW ALBANY
State IN
ZIP 47150
Phone 812 948-0953
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2023
Certificate Expiration Date 12/10/2025
Facility Type Pharmacy
Lab Director PHELICISIMA ROBERTS

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