51D1091983 CLIA NUMBER - KROGER PHARMACY # 714

Laboratory Demographics

  • CLIA Code: 51D1091983
  • Facility Name: KROGER PHARMACY # 714
  • Facility Address: 350 PATTESON DRIVE
    MORGANTOWN, WV
    ZIP 26505
  • Facility Phone: 304 599-8316
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRIS KOON
  • NPI Number: 1861426645
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D1091983
LAB Type Pharmacy
Facility Name KROGER PHARMACY # 714
Street 350 PATTESON DRIVE
City MORGANTOWN
State WV
ZIP 26505
Phone 304 599-8316
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Pharmacy
Lab Director CHRIS KOON

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