49D2004423 CLIA NUMBER - KROGER PHARMACY

Laboratory Demographics

  • CLIA Code: 49D2004423
  • Facility Name: KROGER PHARMACY
  • Facility Address: 1904 EMMET STREET
    CHARLOTTESVILLE, VA
    ZIP 22901
  • Facility Phone: 434 295-2132
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREA BROOKHART
  • NPI Number: 1538184254
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2004423
LAB Type Pharmacy
Facility Name KROGER PHARMACY
Street 1904 EMMET STREET
City CHARLOTTESVILLE
State VA
ZIP 22901
Phone 434 295-2132
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2024
Certificate Expiration Date 3/3/2026
Facility Type Pharmacy
Lab Director ANDREA BROOKHART

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