18D1036528 CLIA NUMBER - KROGER PHARMACY L 535

Laboratory Demographics

  • CLIA Code: 18D1036528
  • Facility Name: KROGER PHARMACY L 535
  • Facility Address: 350 WEST 31 W BYPASS
    BOWLING GREEN, KY
    ZIP 42101
  • Facility Phone: 270 796-6067
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. JEREMY CRAIN
  • NPI Number: 1619901436
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D1036528
LAB Type Pharmacy
Facility Name KROGER PHARMACY L 535
Street 350 WEST 31 W BYPASS
City BOWLING GREEN
State KY
ZIP 42101
Phone 270 796-6067
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Pharmacy
Lab Director MR. JEREMY CRAIN

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