44D2000734 CLIA NUMBER - KROGER PHARMACY L-518

Laboratory Demographics

  • CLIA Code: 44D2000734
  • Facility Name: KROGER PHARMACY L-518
  • Facility Address: 5544 OLD HICKORY RD ATTN PHARMACY
    HERMITAGE, TN
    ZIP 37076
  • Facility Phone: 615 883-0332
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. MARC WATKINS
  • NPI Number: 1124052857
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2000734
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-518
Street 5544 OLD HICKORY RD ATTN PHARMACY
City HERMITAGE
State TN
ZIP 37076
Phone 615 883-0332
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Pharmacy
Lab Director DR. MARC WATKINS

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