49D2098295 CLIA NUMBER - KROGER PHARMACY #517

Laboratory Demographics

  • CLIA Code: 49D2098295
  • Facility Name: KROGER PHARMACY #517
  • Facility Address: 11895 WEST BROAD STREET
    RICHMOND, VA
    ZIP 23233
  • Facility Phone: 804 360-3268
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELE FOUNTAIN
  • NPI Number: 1508890385
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2098295
LAB Type Pharmacy
Facility Name KROGER PHARMACY #517
Street 11895 WEST BROAD STREET
City RICHMOND
State VA
ZIP 23233
Phone 804 360-3268
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Pharmacy
Lab Director MICHELE FOUNTAIN

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This page was last updated on: 3/20/2025