44D1076144 CLIA NUMBER - KROGER PHARMACY 25-415

Laboratory Demographics

  • CLIA Code: 44D1076144
  • Facility Name: KROGER PHARMACY 25-415
  • Facility Address: 1366 POPLAR AVENUE ATTN PHARMACY
    MEMPHIS, TN
    ZIP 38104
  • Facility Phone: 901 272-7883
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. MARC WATKINS
  • NPI Number: 1720012453
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D1076144
LAB Type Pharmacy
Facility Name KROGER PHARMACY 25-415
Street 1366 POPLAR AVENUE ATTN PHARMACY
City MEMPHIS
State TN
ZIP 38104
Phone 901 272-7883
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Pharmacy
Lab Director DR. MARC WATKINS

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