44D1009238 CLIA NUMBER - KROGER PHARMACY #410

Laboratory Demographics

  • CLIA Code: 44D1009238
  • Facility Name: KROGER PHARMACY #410
  • Facility Address: 676 GERMANTOWN PARKWAY ATTN PHARMACY
    CORDOVA, TN
    ZIP 38018
  • Facility Phone: 901 756-1138
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. MARC WATKINS
  • NPI Number: 1669711503
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 44D1009238
LAB Type Pharmacy
Facility Name KROGER PHARMACY #410
Street 676 GERMANTOWN PARKWAY ATTN PHARMACY
City CORDOVA
State TN
ZIP 38018
Phone 901 756-1138
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Pharmacy
Lab Director DR. MARC WATKINS

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