14D1078328 CLIA NUMBER - KROGER PHARMACY 982 THE KROGER COMPANY #21-982

Laboratory Demographics

  • CLIA Code: 14D1078328
  • Facility Name: KROGER PHARMACY 982 THE KROGER COMPANY #21-982
  • Facility Address: 2399 N BLOOMINGTON ST - ATTN PHARMACY MANAGER
    STREATOR, IL
    ZIP 61364
  • Facility Phone: 815 672-6874
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES PARR
  • NPI Number: 1326111949
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1078328
LAB Type Pharmacy
Facility Name KROGER PHARMACY 982 THE KROGER COMPANY #21-982
Street 2399 N BLOOMINGTON ST - ATTN PHARMACY MANAGER
City STREATOR
State IL
ZIP 61364
Phone 815 672-6874
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2024
Certificate Expiration Date 1/7/2026
Facility Type Pharmacy
Lab Director JAMES PARR

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