51D1091984 CLIA NUMBER - KROGER PHARMACY # 730

Laboratory Demographics

  • CLIA Code: 51D1091984
  • Facility Name: KROGER PHARMACY # 730
  • Facility Address: 450 11TH STREET
    ELKINS, WV
    ZIP 26241
  • Facility Phone: 304 636-6891
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRIS KOON
  • NPI Number: 1841224623
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D1091984
LAB Type Pharmacy
Facility Name KROGER PHARMACY # 730
Street 450 11TH STREET
City ELKINS
State WV
ZIP 26241
Phone 304 636-6891
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