25D1021484 CLIA NUMBER - KROGER PHARMACY #492

Laboratory Demographics

  • CLIA Code: 25D1021484
  • Facility Name: KROGER PHARMACY #492
  • Facility Address: 1070 HWY 51
    MADISON, MS
    ZIP 39110
  • Facility Phone: 513 698-1878
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CYNTHIA B. FISHER
  • NPI Number: 1043691009
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D1021484
LAB Type Pharmacy
Facility Name KROGER PHARMACY #492
Street 1070 HWY 51
City MADISON
State MS
ZIP 39110
Phone 513 698-1878
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 CYNTHIA B. FISHER

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