49D1093848 CLIA NUMBER - KROGER PHARMACY #375

Laboratory Demographics

  • CLIA Code: 49D1093848
  • Facility Name: KROGER PHARMACY #375
  • Facility Address: 3971 BRAMBLETON AVENUE
    ROANOKE, VA
    ZIP 24018
  • Facility Phone: 540 725-3808
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMIE REMINES
  • NPI Number: 1063446839
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D1093848
LAB Type Pharmacy
Facility Name KROGER PHARMACY #375
Street 3971 BRAMBLETON AVENUE
City ROANOKE
State VA
ZIP 24018
Phone 540 725-3808
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2025
Certificate Expiration Date 1/4/2027
Facility Type Pharmacy
Lab Director JAMIE REMINES

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