18D1107688 CLIA NUMBER - KROGER PHARMACY L-224

Laboratory Demographics

  • CLIA Code: 18D1107688
  • Facility Name: KROGER PHARMACY L-224
  • Facility Address: 2200 BROWNSBORO ROAD
    LOUISVILLE, KY
    ZIP 40206
  • Facility Phone: 502 894-8759
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. PHELIRISIMA ROBERTS
  • NPI Number: 1609800440
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D1107688
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-224
Street 2200 BROWNSBORO ROAD
City LOUISVILLE
State KY
ZIP 40206
Phone 502 894-8759
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2023
Certificate Expiration Date 11/11/2025
Facility Type Pharmacy
Lab Director MS. PHELIRISIMA ROBERTS

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