49D1067796 CLIA NUMBER - KROGER PHARMACY

Laboratory Demographics

  • CLIA Code: 49D1067796
  • Facility Name: KROGER PHARMACY
  • Facility Address: 3330 VIRGINIA BEACH BOULEVARD
    VIRGINIA BEACH, VA
    ZIP 23452
  • Facility Phone: 757 486-4184
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANNE MANE WRAY
  • NPI Number: 1700810587
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D1067796
LAB Type Pharmacy
Facility Name KROGER PHARMACY
Street 3330 VIRGINIA BEACH BOULEVARD
City VIRGINIA BEACH
State VA
ZIP 23452
Phone 757 486-4184
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Pharmacy
Lab Director ANNE MANE WRAY

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