18D2000224 CLIA NUMBER - KROGER PHARMACY L-389

Laboratory Demographics

  • CLIA Code: 18D2000224
  • Facility Name: KROGER PHARMACY L-389
  • Facility Address: 5929 TIMBER RIDGE DR
    PROSPECT, KY
    ZIP 40059
  • Facility Phone: 502 292-2471
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. PHELIRISIMA ROBERTS
  • NPI Number: 1518991355
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2000224
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-389
Street 5929 TIMBER RIDGE DR
City PROSPECT
State KY
ZIP 40059
Phone 502 292-2471
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2023
Certificate Expiration Date 11/23/2025
Facility Type Pharmacy
Lab Director MS. PHELIRISIMA ROBERTS

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