19D2016590 CLIA NUMBER - KROGER PHARMACY # 34-747

Laboratory Demographics

  • CLIA Code: 19D2016590
  • Facility Name: KROGER PHARMACY # 34-747
  • Facility Address: 1421 S BEGLIS PKWY
    SULPHUR, LA
    ZIP 70663
  • Facility Phone: 337 528-9918
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FELICIA M. BROUSSARD
  • NPI Number: 1790858215
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2016590
LAB Type Pharmacy
Facility Name KROGER PHARMACY # 34-747
Street 1421 S BEGLIS PKWY
City SULPHUR
State LA
ZIP 70663
Phone 337 528-9918
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2024
Certificate Expiration Date 11/18/2026
Facility Type Pharmacy
Lab Director FELICIA M. BROUSSARD

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