18D1095499 CLIA NUMBER - KROGER PHARMACY L-718

Laboratory Demographics

  • CLIA Code: 18D1095499
  • Facility Name: KROGER PHARMACY L-718
  • Facility Address: 1670 STARIGHT DRIVE
    OWENSBORO, KY
    ZIP 42301
  • Facility Phone: 270 926-3240
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. PHELICISIMA ROBERTS
  • NPI Number: 1730104431
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D1095499
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-718
Street 1670 STARIGHT DRIVE
City OWENSBORO
State KY
ZIP 42301
Phone 270 926-3240
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 MS. PHELICISIMA ROBERTS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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