49D2152229 CLIA NUMBER - KROGER PHARMACY #029-573

Laboratory Demographics

  • CLIA Code: 49D2152229
  • Facility Name: KROGER PHARMACY #029-573
  • Facility Address: 6500-C G WASHINGTON MEM HWY
    GRAFTON, VA
    ZIP 23692
  • Facility Phone: 757 947-1244
  • Facility Type: Other - PHARMACY
  • Facility Type: Waiver
  • Lab Director: JESSICA LEWIS
  • NPI Number: 1437655461
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2152229
LAB Type Other - PHARMACY
Facility Name KROGER PHARMACY #029-573
Street 6500-C G WASHINGTON MEM HWY
City GRAFTON
State VA
ZIP 23692
Phone 757 947-1244
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2024
Certificate Expiration Date 8/5/2026
Facility Type Other - PHARMACY
Lab Director JESSICA LEWIS

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This page was last updated on: 6/4/2025