49D2069020 CLIA NUMBER - KROGER PHARMACY #359

Laboratory Demographics

  • CLIA Code: 49D2069020
  • Facility Name: KROGER PHARMACY #359
  • Facility Address: 1159 EMMET STREET ATTN PHARMACIST IN CHARGE
    CHARLOTTESVILLE, VA
    ZIP 22901
  • Facility Phone: 434 245-0279
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREA BROOKHART
  • NPI Number: 1831431642
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2069020
LAB Type Pharmacy
Facility Name KROGER PHARMACY #359
Street 1159 EMMET STREET ATTN PHARMACIST IN CHARGE
City CHARLOTTESVILLE
State VA
ZIP 22901
Phone 434 245-0279
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Pharmacy
Lab Director ANDREA BROOKHART

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