44D1013777 CLIA NUMBER - KROGER PHARMACY 25-481

Laboratory Demographics

  • CLIA Code: 44D1013777
  • Facility Name: KROGER PHARMACY 25-481
  • Facility Address: 3685 HOUSTON LEVEE ROAD ATTN PHARMACY
    COLLIERVILLE, TN
    ZIP 38017
  • Facility Phone: 901 854-2707
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. MARC WATKINS
  • NPI Number: 1093730715
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D1013777
LAB Type Pharmacy
Facility Name KROGER PHARMACY 25-481
Street 3685 HOUSTON LEVEE ROAD ATTN PHARMACY
City COLLIERVILLE
State TN
ZIP 38017
Phone 901 854-2707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director DR. MARC WATKINS

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