25D1021490 CLIA NUMBER - KROGER PHARMACY #449

Laboratory Demographics

  • CLIA Code: 25D1021490
  • Facility Name: KROGER PHARMACY #449
  • Facility Address: 1167 HWY 49 SOUTH
    RICHLAND, MS
    ZIP 39218
  • Facility Phone: 601 664-0602
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CYNTHIA B. FISHER
  • NPI Number: 1831123611
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D1021490
LAB Type Pharmacy
Facility Name KROGER PHARMACY #449
Street 1167 HWY 49 SOUTH
City RICHLAND
State MS
ZIP 39218
Phone 601 664-0602
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

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