18D2000582 CLIA NUMBER - KROGER PHARMACY 763

Laboratory Demographics

  • CLIA Code: 18D2000582
  • Facility Name: KROGER PHARMACY 763
  • Facility Address: 520 NORTH 35TH STREET
    LOUISVILLE, KY
    ZIP 40212
  • Facility Phone: 502 776-3765
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. PHELIRISIMA ROBERTS
  • NPI Number: 1568496321
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 18D2000582
LAB Type Pharmacy
Facility Name KROGER PHARMACY 763
Street 520 NORTH 35TH STREET
City LOUISVILLE
State KY
ZIP 40212
Phone 502 776-3765
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

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