49D1064636 CLIA NUMBER - KROGER PHARMACY

Laboratory Demographics

  • CLIA Code: 49D1064636
  • Facility Name: KROGER PHARMACY
  • Facility Address: 850 STATLER BOULEVARD
    STAUNTON, VA
    ZIP 24401
  • Facility Phone: 540 885-9875
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREA BROOKHART
  • NPI Number: 1174557946
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D1064636
LAB Type Pharmacy
Facility Name KROGER PHARMACY
Street 850 STATLER BOULEVARD
City STAUNTON
State VA
ZIP 24401
Phone 540 885-9875
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Pharmacy
Lab Director ANDREA BROOKHART

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