18D2000239 CLIA NUMBER - KROGER PHARMACY L-522

Laboratory Demographics

  • CLIA Code: 18D2000239
  • Facility Name: KROGER PHARMACY L-522
  • Facility Address: 1213 SKYLINE DRIVE
    HOPKINSVILLE, KY
    ZIP 42240
  • Facility Phone: 270 886-4594
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. JEREMY CRAIN
  • NPI Number: 1598799355
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2000239
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-522
Street 1213 SKYLINE DRIVE
City HOPKINSVILLE
State KY
ZIP 42240
Phone 270 886-4594
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 MR. JEREMY CRAIN

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