44D1009265 CLIA NUMBER - KROGER PHARMACY #430

Laboratory Demographics

  • CLIA Code: 44D1009265
  • Facility Name: KROGER PHARMACY #430
  • Facility Address: 540 S MENDENHALL STREET #16 ATTN PHARMACY
    MEMPHIS, TN
    ZIP 38117
  • Facility Phone: 901 683-8843
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. MARC WATKINS
  • NPI Number: 1558641084
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D1009265
LAB Type Pharmacy
Facility Name KROGER PHARMACY #430
Street 540 S MENDENHALL STREET #16 ATTN PHARMACY
City MEMPHIS
State TN
ZIP 38117
Phone 901 683-8843
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2025
Certificate Expiration Date 2/10/2027
Facility Type Pharmacy
Lab Director DR. MARC WATKINS

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