15D0999295 CLIA NUMBER - KROGER PHARMACY 895

Laboratory Demographics

  • CLIA Code: 15D0999295
  • Facility Name: KROGER PHARMACY 895
  • Facility Address: 10005 E 116TH ST
    FISHERS, IN
    ZIP 46038
  • Facility Phone: (317) 913-5505
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA HANOVER-PAYNE
  • NPI Number: 1346313665
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D0999295
LAB Type Pharmacy
Facility Name KROGER PHARMACY 895
Street 10005 E 116TH ST
City FISHERS
State IN
ZIP 46038
Phone 3179135505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2026
Certificate Expiration Date 5/8/2028
Facility Type Pharmacy
Lab Director LISA HANOVER-PAYNE

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This page was last updated on: 5/18/2026