44D1009243 CLIA NUMBER - KROGER PHARMACY #486

Laboratory Demographics

  • CLIA Code: 44D1009243
  • Facility Name: KROGER PHARMACY #486
  • Facility Address: 1212 E SHELBY DR ATTN PHARMACY
    MEMPHIS, TN
    ZIP 38116
  • Facility Phone: 901 346-3336
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. MARC WATKINS
  • NPI Number: 1295769925
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D1009243
LAB Type Pharmacy
Facility Name KROGER PHARMACY #486
Street 1212 E SHELBY DR ATTN PHARMACY
City MEMPHIS
State TN
ZIP 38116
Phone 901 346-3336
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