44D1059311 CLIA NUMBER - KROGER PHARMACY 25-425

Laboratory Demographics

  • CLIA Code: 44D1059311
  • Facility Name: KROGER PHARMACY 25-425
  • Facility Address: 2632 FRAYSER BLVD ATTN PHARMACY
    MEMPHIS, TN
    ZIP 38127
  • Facility Phone: 901 353-8284
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. MARC WATKINS
  • NPI Number: 1164456893
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D1059311
LAB Type Pharmacy
Facility Name KROGER PHARMACY 25-425
Street 2632 FRAYSER BLVD ATTN PHARMACY
City MEMPHIS
State TN
ZIP 38127
Phone 901 353-8284
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Pharmacy
Lab Director DR. MARC WATKINS

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This page was last updated on: 6/4/2025