49D0991959 CLIA NUMBER - KROGER PHARMACY 350

Laboratory Demographics

  • CLIA Code: 49D0991959
  • Facility Name: KROGER PHARMACY 350
  • Facility Address: 240 WEST COMMONWEALTH BOULEVARD
    MARTINSVILLE, VA
    ZIP 24112
  • Facility Phone: 540 666-3014
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREA BROOKHART
  • NPI Number: 1700810579
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 49D0991959
LAB Type Pharmacy
Facility Name KROGER PHARMACY 350
Street 240 WEST COMMONWEALTH BOULEVARD
City MARTINSVILLE
State VA
ZIP 24112
Phone 540 666-3014
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2025
Certificate Expiration Date 10/2/2027
Facility Type Pharmacy
Lab Director ANDREA BROOKHART

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