44D1064669 CLIA NUMBER - KROGER PHARMACY

Laboratory Demographics

  • CLIA Code: 44D1064669
  • Facility Name: KROGER PHARMACY
  • Facility Address: 112 SUNSET DRIVE ATTN PHARMACY
    JOHNSON CITY, TN
    ZIP 37601
  • Facility Phone: 423 283-0522
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. MARC WATKINS
  • NPI Number: 1881628527
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D1064669
LAB Type Pharmacy
Facility Name KROGER PHARMACY
Street 112 SUNSET DRIVE ATTN PHARMACY
City JOHNSON CITY
State TN
ZIP 37601
Phone 423 283-0522
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2025
Certificate Expiration Date 2/11/2027
Facility Type Pharmacy
Lab Director DR. MARC WATKINS

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