25D1021483 CLIA NUMBER - KROGER PHARMACY #471

Laboratory Demographics

  • CLIA Code: 25D1021483
  • Facility Name: KROGER PHARMACY #471
  • Facility Address: 960 WEST MAIN STREET
    TUPELO, MS
    ZIP 38801
  • Facility Phone: 662 840-8559
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CINDY FISHER
  • NPI Number: 1477587251
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D1021483
LAB Type Pharmacy
Facility Name KROGER PHARMACY #471
Street 960 WEST MAIN STREET
City TUPELO
State MS
ZIP 38801
Phone 662 840-8559
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2024
Certificate Expiration Date 1/22/2026
Facility Type Pharmacy
Lab Director CINDY FISHER

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This page was last updated on: 3/20/2025