15D1009883 CLIA NUMBER - KROGER PHARMACY J906

Laboratory Demographics

  • CLIA Code: 15D1009883
  • Facility Name: KROGER PHARMACY J906
  • Facility Address: 2550 LAKE CIRCLE DR
    INDIANAPOLIS, IN
    ZIP 46268
  • Facility Phone: 317 879-2465
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW BUDI
  • NPI Number: 1841363462
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1009883
LAB Type Pharmacy
Facility Name KROGER PHARMACY J906
Street 2550 LAKE CIRCLE DR
City INDIANAPOLIS
State IN
ZIP 46268
Phone 317 879-2465
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Pharmacy
Lab Director MATTHEW BUDI

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