18D1093942 CLIA NUMBER - KROGER PHARMACY L-186

Laboratory Demographics

  • CLIA Code: 18D1093942
  • Facility Name: KROGER PHARMACY L-186
  • Facility Address: 2219 HOLIDAY MANOR
    LOUISVILLE, KY
    ZIP 40222
  • Facility Phone: (502) 394-9483
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. PHELIRISIMA ROBERTS
  • NPI Number: 1093749814
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D1093942
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-186
Street 2219 HOLIDAY MANOR
City LOUISVILLE
State KY
ZIP 40222
Phone 5023949483
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Pharmacy
Lab Director MS. PHELIRISIMA ROBERTS

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This page was last updated on: 5/18/2026