18D1001276 CLIA NUMBER - KROGER PHARMACY L-387

Laboratory Demographics

  • CLIA Code: 18D1001276
  • Facility Name: KROGER PHARMACY L-387
  • Facility Address: 291 N HUBBARDS LANE, SUITE 130
    LOUISVILLE, KY
    ZIP 40207
  • Facility Phone: 502 895-5685
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PHELIRISIMA ROBERTS
  • NPI Number: 1467486282
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D1001276
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-387
Street 291 N HUBBARDS LANE, SUITE 130
City LOUISVILLE
State KY
ZIP 40207
Phone 502 895-5685
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2024
Certificate Expiration Date 7/7/2026
Facility Type Pharmacy
Lab Director PHELIRISIMA ROBERTS

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