18D1107691 CLIA NUMBER - KROGER PHARMACY L-332

Laboratory Demographics

  • CLIA Code: 18D1107691
  • Facility Name: KROGER PHARMACY L-332
  • Facility Address: 4211 SOUTH 3RD STREET
    LOUISVILLE, KY
    ZIP 40214
  • Facility Phone: 502 363-3111
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. PHELIRISIMA ROBERTS
  • NPI Number: 1720003502
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D1107691
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-332
Street 4211 SOUTH 3RD STREET
City LOUISVILLE
State KY
ZIP 40214
Phone 502 363-3111
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