18D2000423 CLIA NUMBER - KROGER PHARMACY L-758

Laboratory Demographics

  • CLIA Code: 18D2000423
  • Facility Name: KROGER PHARMACY L-758
  • Facility Address: 234 EASTBROOKE PKWY
    MOUNT WASHINGTON, KY
    ZIP 40047
  • Facility Phone: 502 538-1241
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. PHELIRISIMA ROBERTS
  • NPI Number: 1477888766
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D2000423
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-758
Street 234 EASTBROOKE PKWY
City MOUNT WASHINGTON
State KY
ZIP 40047
Phone 502 538-1241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2023
Certificate Expiration Date 11/30/2025
Facility Type Pharmacy
Lab Director MS. PHELIRISIMA 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