CLIA lab
CLIA 25D1090849: Kroger Pharmacy #466
Vicksburg, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D1090849 belongs to Kroger Pharmacy #466 in Vicksburg, MS.
Certificate of Waiver, effective October 20, 2026, expires October 19, 2028.
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
- October 20, 2026
- Certificate expiration
- October 19, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 20, 2008
- Facility type
- Industrial
- 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
- 25D1090849
- Lab name
- Kroger Pharmacy #466
- Address
- 3408 Pemberton Square Blvd, Vicksburg, MS 39180
- Phone
- (601) 638-3251
Annual test volume the lab reported
- Waived tests
- 3,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Biometric Solutions LLCCertificate of Waiver, Independent25D2306626
- Bluffs Rehabilitation and Healthcare Center, theCertificate of Waiver, Skilled nursing or nursing facility25D0708259
- Caring Hands Ppec of VicksburgCertificate of Waiver, Other25D2111535
- Center for Pregnancy ChoicesCertificate of Waiver, Community clinic25D2026952
- Complete Care Rural Health ClinicCertificate of Waiver, Physician office25D1068392
- Empower Childrens Clinic-VicksburgCertificate of Waiver, Physician office25D2299095
- Fast Pace Mississippi, PLLCCertificate of Waiver, Physician office25D2191040
- Fresenius Medical Care Vicksburg Home LLCCertificate of Waiver, End stage renal disease dialysis facility25D2226035
- Gi Associates EndoscopyCertificate of Waiver, Ambulatory surgery center25D1055997
Related
Questions
What is the CLIA number for Kroger Pharmacy #466 in Vicksburg?
25D1090849, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kroger Pharmacy #466 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D1090849 expire?
The CMS file lists October 19, 2028 as the certificate expiration date; the certificate took effect October 20, 2026.