44D1011004 CLIA NUMBER - KROGER PHARMACY 488

Laboratory Demographics

  • CLIA Code: 44D1011004
  • Facility Name: KROGER PHARMACY 488
  • Facility Address: 3444 PLAZA AVE ATTN PHARMACY
    MEMPHIS, TN
    ZIP 38111
  • Facility Phone: 901 324-1013
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. MARC WATKINS
  • NPI Number: 1063446706
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D1011004
LAB Type Pharmacy
Facility Name KROGER PHARMACY 488
Street 3444 PLAZA AVE ATTN PHARMACY
City MEMPHIS
State TN
ZIP 38111
Phone 901 324-1013
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2024
Certificate Expiration Date 1/28/2026
Facility Type Pharmacy
Lab Director DR. MARC WATKINS

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