51D1068458 CLIA NUMBER - KROGER PHARMACY #790

Laboratory Demographics

  • CLIA Code: 51D1068458
  • Facility Name: KROGER PHARMACY #790
  • Facility Address: 133 BECKLEY CROSSING
    BECKLEY, WV
    ZIP 25801
  • Facility Phone: 304 252-3480
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRIS KOON
  • NPI Number: 1699709303
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D1068458
LAB Type Pharmacy
Facility Name KROGER PHARMACY #790
Street 133 BECKLEY CROSSING
City BECKLEY
State WV
ZIP 25801
Phone 304 252-3480
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director CHRIS KOON

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