51D1079535 CLIA NUMBER - KROGER PHARMACY #813

Laboratory Demographics

  • CLIA Code: 51D1079535
  • Facility Name: KROGER PHARMACY #813
  • Facility Address: 500 SUNCREST TOWN CENTRE DRIVE
    MORGANTOWN, WV
    ZIP 26505
  • Facility Phone: 304 285-6781
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRIS KOON
  • NPI Number: 1316124803
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D1079535
LAB Type Pharmacy
Facility Name KROGER PHARMACY #813
Street 500 SUNCREST TOWN CENTRE DRIVE
City MORGANTOWN
State WV
ZIP 26505
Phone 304 285-6781
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type Pharmacy
Lab Director CHRIS KOON

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