15D1021822 CLIA NUMBER - KROGER PHARMACY 907

Laboratory Demographics

  • CLIA Code: 15D1021822
  • Facility Name: KROGER PHARMACY 907
  • Facility Address: 1600 S OHIO ST
    MARTINSVILLE, IN
    ZIP 46151
  • Facility Phone: 765 342-6213
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRAVIS KLEINGARTNER
  • NPI Number: 1295808715
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D1021822
LAB Type Pharmacy
Facility Name KROGER PHARMACY 907
Street 1600 S OHIO ST
City MARTINSVILLE
State IN
ZIP 46151
Phone 765 342-6213
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2024
Certificate Expiration Date 2/1/2026
Facility Type Pharmacy
Lab Director TRAVIS KLEINGARTNER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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