15D0986650 CLIA NUMBER - KROGER PHARMACY 21-848

Laboratory Demographics

  • CLIA Code: 15D0986650
  • Facility Name: KROGER PHARMACY 21-848
  • Facility Address: 3050 MERIDIAN ST
    ANDERSON, IN
    ZIP 46016
  • Facility Phone: 765 644-2421
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ZACHARY HUSTON
  • NPI Number: 1750454278
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D0986650
LAB Type Pharmacy
Facility Name KROGER PHARMACY 21-848
Street 3050 MERIDIAN ST
City ANDERSON
State IN
ZIP 46016
Phone 765 644-2421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Pharmacy
Lab Director ZACHARY HUSTON

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