15D1021823 CLIA NUMBER - KROGER LIMITED PARTNERSHIP

Laboratory Demographics

  • CLIA Code: 15D1021823
  • Facility Name: KROGER LIMITED PARTNERSHIP
  • Facility Address: 5960 CASTLEWAY W DR
    INDIANAPOLIS, IN
    ZIP 46250
  • Facility Phone: 317 579-8434
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: LESLIE LAKE
  • NPI Number: 1659576395
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1021823
LAB Type Other
Facility Name KROGER LIMITED PARTNERSHIP
Street 5960 CASTLEWAY W DR
City INDIANAPOLIS
State IN
ZIP 46250
Phone 317 579-8434
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 Other
Lab Director LESLIE LAKE

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