25D1021486 CLIA NUMBER - KROGER PHARMACY #478

Laboratory Demographics

  • CLIA Code: 25D1021486
  • Facility Name: KROGER PHARMACY #478
  • Facility Address: 2380 MT PLEASANT
    HERNANDO, MS
    ZIP 38632
  • Facility Phone: 662 429-5327
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CYNTHIA B. FISHER
  • NPI Number: 1568496347
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D1021486
LAB Type Pharmacy
Facility Name KROGER PHARMACY #478
Street 2380 MT PLEASANT
City HERNANDO
State MS
ZIP 38632
Phone 662 429-5327
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Pharmacy
Lab Director CYNTHIA B. FISHER

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