18D2000579 CLIA NUMBER - KROGER PHARMACY L-713

Laboratory Demographics

  • CLIA Code: 18D2000579
  • Facility Name: KROGER PHARMACY L-713
  • Facility Address: 995 SOUTH MAIN STREET
    NICHOLASVILLE, KY
    ZIP 40356
  • Facility Phone: 859 881-9086
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. PHELIRISIMA ROBERTS
  • NPI Number: 1336173152
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2000579
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-713
Street 995 SOUTH MAIN STREET
City NICHOLASVILLE
State KY
ZIP 40356
Phone 859 881-9086
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Pharmacy
Lab Director MS. PHELIRISIMA ROBERTS

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