44D2000922 CLIA NUMBER - KROGER PHARMACY L-575

Laboratory Demographics

  • CLIA Code: 44D2000922
  • Facility Name: KROGER PHARMACY L-575
  • Facility Address: 2600 MEMORIAL BLVD ATTN PHARMACY
    SPRINGFIELD, TN
    ZIP 37172
  • Facility Phone: 615 382-9844
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. MARC WATKINS
  • NPI Number: 1376577007
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2000922
LAB Type Pharmacy
Facility Name KROGER PHARMACY L-575
Street 2600 MEMORIAL BLVD ATTN PHARMACY
City SPRINGFIELD
State TN
ZIP 37172
Phone 615 382-9844
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Pharmacy
Lab Director DR. MARC WATKINS

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