18D2002874 CLIA NUMBER - KROGER PHARMACY 796

Laboratory Demographics

  • CLIA Code: 18D2002874
  • Facility Name: KROGER PHARMACY 796
  • Facility Address: 370 DIEDRICH BOULEVARD
    ASHLAND, KY
    ZIP 41101
  • Facility Phone: 606 325-0611
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELE FOUNTAIN
  • NPI Number: 1417972191
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2002874
LAB Type Pharmacy
Facility Name KROGER PHARMACY 796
Street 370 DIEDRICH BOULEVARD
City ASHLAND
State KY
ZIP 41101
Phone 606 325-0611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Pharmacy
Lab Director MICHELE FOUNTAIN

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