49D1065143 CLIA NUMBER - KROGER PHARMACY

Laboratory Demographics

  • CLIA Code: 49D1065143
  • Facility Name: KROGER PHARMACY
  • Facility Address: 5050 RUTGERS STREET
    ROANOKE, VA
    ZIP 24012
  • Facility Phone: (540) 362-3806
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMIE REMINES
  • NPI Number: 1356375125
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D1065143
LAB Type Pharmacy
Facility Name KROGER PHARMACY
Street 5050 RUTGERS STREET
City ROANOKE
State VA
ZIP 24012
Phone 5403623806
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2025
Certificate Expiration Date 2/21/2027
Facility Type Pharmacy
Lab Director JAMIE REMINES

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This page was last updated on: 5/18/2026