18D1032498 CLIA NUMBER - KROGER PHARMACY L-752

Laboratory Demographics

  • CLIA Code: 18D1032498
  • Facility Name: KROGER PHARMACY L-752
  • Facility Address: 3165 SOUTH 2ND STREET
    LOUISVILLE, KY
    ZIP 40208
  • Facility Phone: 502 368-6153
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. PHELIRISIMA ROBERTS
  • NPI Number: 1588698344
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D1032498
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-752
Street 3165 SOUTH 2ND STREET
City LOUISVILLE
State KY
ZIP 40208
Phone 502 368-6153
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2024
Certificate Expiration Date 10/24/2026
Facility Type Pharmacy
Lab Director MS. PHELIRISIMA ROBERTS

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