44D1011005 CLIA NUMBER - KROGER PHARMACY #456

Laboratory Demographics

  • CLIA Code: 44D1011005
  • Facility Name: KROGER PHARMACY #456
  • Facility Address: 7615 HIGHWAY 70
    BARTLETT, TN
    ZIP 38133
  • Facility Phone: (901) 758-3625
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CYNTHIA FISHER
  • NPI Number: 1710267240
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D1011005
LAB Type Pharmacy
Facility Name KROGER PHARMACY #456
Street 7615 HIGHWAY 70
City BARTLETT
State TN
ZIP 38133
Phone 9017583625
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Pharmacy
Lab Director CYNTHIA FISHER

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This page was last updated on: 6/29/2026