18D2095622 CLIA NUMBER - KROGER PHARMACY #784

Laboratory Demographics

  • CLIA Code: 18D2095622
  • Facility Name: KROGER PHARMACY #784
  • Facility Address: 704 E EUCLID AVE
    LEXINGTON, KY
    ZIP 40502
  • Facility Phone: 859 687-3270
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. PHELIRISIMA ROBERTS
  • NPI Number: 1477950285
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2095622
LAB Type Pharmacy
Facility Name KROGER PHARMACY #784
Street 704 E EUCLID AVE
City LEXINGTON
State KY
ZIP 40502
Phone 859 687-3270
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/8/2025
Certificate Expiration Date 5/7/2027
Facility Type Pharmacy
Lab Director MS. PHELIRISIMA ROBERTS

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