44D1097495 CLIA NUMBER - KROGER PHARMACY L-561

Laboratory Demographics

  • CLIA Code: 44D1097495
  • Facility Name: KROGER PHARMACY L-561
  • Facility Address: 1905 N JACKSON SUITE 500 ATTN PHARMACY
    TULLAHOMA, TN
    ZIP 37388
  • Facility Phone: 931 454-0482
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARC WATKINS
  • NPI Number: 1871527515
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 44D1097495
LAB Type Physician Office
Facility Name KROGER PHARMACY L-561
Street 1905 N JACKSON SUITE 500 ATTN PHARMACY
City TULLAHOMA
State TN
ZIP 37388
Phone 931 454-0482
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director DR. MARC WATKINS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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