18D1018964 CLIA NUMBER - KROGER PHARMACY

Laboratory Demographics

  • CLIA Code: 18D1018964
  • Facility Name: KROGER PHARMACY
  • Facility Address: 1808 ALEXANDRIA DRIVE
    LEXINGTON, KY
    ZIP 40504
  • Facility Phone: 859 277-0767
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. PHELIRISIMA ROBERTS
  • NPI Number: 1841224664
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D1018964
LAB Type Pharmacy
Facility Name KROGER PHARMACY
Street 1808 ALEXANDRIA DRIVE
City LEXINGTON
State KY
ZIP 40504
Phone 859 277-0767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Pharmacy
Lab Director MS. PHELIRISIMA ROBERTS

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This page was last updated on: 3/20/2025