15D0974279 CLIA NUMBER - KROGER PHARMACY #938

Laboratory Demographics

  • CLIA Code: 15D0974279
  • Facility Name: KROGER PHARMACY #938
  • Facility Address: 906 S MERRIFIELD AVE
    MISHAWAKA, IN
    ZIP 46544
  • Facility Phone: 219 256-7522
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER FREY
  • NPI Number: 1023181641
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D0974279
LAB Type Pharmacy
Facility Name KROGER PHARMACY #938
Street 906 S MERRIFIELD AVE
City MISHAWAKA
State IN
ZIP 46544
Phone 219 256-7522
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Pharmacy
Lab Director JENNIFER FREY

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