26D1022367 CLIA NUMBER - KROGER PHARMACY #386

Laboratory Demographics

  • CLIA Code: 26D1022367
  • Facility Name: KROGER PHARMACY #386
  • Facility Address: 2770 NORTH WESTWOOD
    POPLAR BLUFF, MO
    ZIP 63901
  • Facility Phone: 573 686-6974
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CYNTHIA FISHER
  • NPI Number: 1376577155
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D1022367
LAB Type Pharmacy
Facility Name KROGER PHARMACY #386
Street 2770 NORTH WESTWOOD
City POPLAR BLUFF
State MO
ZIP 63901
Phone 573 686-6974
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2024
Certificate Expiration Date 2/12/2026
Facility Type Pharmacy
Lab Director CYNTHIA FISHER

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