CLIA lab
CLIA 04D2122276: Kroger Pharmacy #409
Jonesboro, AR. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 04D2122276 belongs to Kroger Pharmacy #409 in Jonesboro, AR.
Certificate of Waiver, effective November 23, 2024, expires November 22, 2026.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- November 23, 2024
- Certificate expiration
- November 22, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 23, 2016
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 04D2122276
- Lab name
- Kroger Pharmacy #409
- Address
- 1725 South Caraway Rd, Jonesboro, AR 72401
- Phone
- (870) 972-4739
- Fax
- (870) 972-5521
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Jonesboro, AR
- Apache Drive Children's ClinicCertificate of Waiver, Physician office04D0875868
- Ar Anatomic Pathology Laboratory/Doctors'Certificate of Compliance, Independent04D0892601
- Arcare - JonesboroCertificate of Waiver, Federally qualified health center04D2049891
- Arcare 141Certificate of Waiver, Federally qualified health center04D2243446
- Arcare 160Certificate of Waiver, Federally qualified health center04D2326381
- Arcare 172Certificate of Waiver, Physician office04D2105851
- Arcare 22Certificate of Waiver, Federally qualified health center04D2008012
- Arcare 55Certificate of Waiver, Federally qualified health center04D1036366
- Arcare 59Certificate of Waiver, Federally qualified health center04D2114808
- Arisa Health IncCertificate of Waiver, Other04D2021886
Related
Questions
What is the CLIA number for Kroger Pharmacy #409 in Jonesboro?
04D2122276, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kroger Pharmacy #409 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 04D2122276 expire?
The CMS file lists November 22, 2026 as the certificate expiration date; the certificate took effect November 23, 2024.