49D1078317 CLIA NUMBER - KROGER PHARMACY #400

Laboratory Demographics

  • CLIA Code: 49D1078317
  • Facility Name: KROGER PHARMACY #400
  • Facility Address: 614 BRANDON AVENUE
    ROANOKE, VA
    ZIP 24015
  • Facility Phone: 540 342-9897
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMIE REMINES
  • NPI Number: 1063446847
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D1078317
LAB Type Pharmacy
Facility Name KROGER PHARMACY #400
Street 614 BRANDON AVENUE
City ROANOKE
State VA
ZIP 24015
Phone 540 342-9897
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2024
Certificate Expiration Date 1/6/2026
Facility Type Pharmacy
Lab Director JAMIE REMINES

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