15D1037201 CLIA NUMBER - KROGER PHARMACY J 965

Laboratory Demographics

  • CLIA Code: 15D1037201
  • Facility Name: KROGER PHARMACY J 965
  • Facility Address: 9835 FALL CREEK RD
    INDIANAPOLIS, IN
    ZIP 46256
  • Facility Phone: 317 577-3486
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: QUOC DO
  • NPI Number: 1487727905
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1037201
LAB Type Pharmacy
Facility Name KROGER PHARMACY J 965
Street 9835 FALL CREEK RD
City INDIANAPOLIS
State IN
ZIP 46256
Phone 317 577-3486
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Pharmacy
Lab Director QUOC DO

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