49D2086536 CLIA NUMBER - KROGER PHARMACY #542

Laboratory Demographics

  • CLIA Code: 49D2086536
  • Facility Name: KROGER PHARMACY #542
  • Facility Address: 1301 FREDERICK BLVD ATTN PHARMACIST IN CHARGE
    PORTSMOUTH, VA
    ZIP 23707
  • Facility Phone: 757 337-5341
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: ANNE HARRISON
  • NPI Number: 1093124505
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2086536
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY #542
Street 1301 FREDERICK BLVD ATTN PHARMACIST IN CHARGE
City PORTSMOUTH
State VA
ZIP 23707
Phone 757 337-5341
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Other - RETAIL PHARMACY
Lab Director ANNE HARRISON

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