15D1006766 CLIA NUMBER - KROGER PHARMACY #021-894

Laboratory Demographics

  • CLIA Code: 15D1006766
  • Facility Name: KROGER PHARMACY #021-894
  • Facility Address: 8745 SOUTH EMERSON AVENUE
    INDIANAPOLIS, IN
    ZIP 46237
  • Facility Phone: (317) 884-3325
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRACY NEWMAN
  • NPI Number: 1104999416
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1006766
LAB Type Pharmacy
Facility Name KROGER PHARMACY #021-894
Street 8745 SOUTH EMERSON AVENUE
City INDIANAPOLIS
State IN
ZIP 46237
Phone 3178843325
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2024
Certificate Expiration Date 11/26/2026
Facility Type Pharmacy
Lab Director TRACY NEWMAN

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