51D1065697 CLIA NUMBER - KROGER PHARMACY #722

Laboratory Demographics

  • CLIA Code: 51D1065697
  • Facility Name: KROGER PHARMACY #722
  • Facility Address: 80 SKYLINE PLAZA DRIVE
    BUCKHANNON, WV
    ZIP 26201
  • Facility Phone: 304 472-0715
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRIS KOON
  • NPI Number: 1427082213
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D1065697
LAB Type Pharmacy
Facility Name KROGER PHARMACY #722
Street 80 SKYLINE PLAZA DRIVE
City BUCKHANNON
State WV
ZIP 26201
Phone 304 472-0715
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2025
Certificate Expiration Date 3/6/2027
Facility Type Pharmacy
Lab Director CHRIS KOON

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