18D1095494 CLIA NUMBER - KROGER PHARMACY L-585

Laboratory Demographics

  • CLIA Code: 18D1095494
  • Facility Name: KROGER PHARMACY L-585
  • Facility Address: 2945 SCOTTTSVILLE ROAD
    BOWLING GREEN, KY
    ZIP 42104
  • Facility Phone: 270 780-9328
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. JEREMY CRAIN
  • NPI Number: 1326063009
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D1095494
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-585
Street 2945 SCOTTTSVILLE ROAD
City BOWLING GREEN
State KY
ZIP 42104
Phone 270 780-9328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Pharmacy
Lab Director MR. JEREMY CRAIN

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