15D1042820 CLIA NUMBER - KROGER PHARMACY 983

Laboratory Demographics

  • CLIA Code: 15D1042820
  • Facility Name: KROGER PHARMACY 983
  • Facility Address: 17447 CAREY RD
    WESTFIELD, IN
    ZIP 46074
  • Facility Phone: 317 867-3022
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HEATHER TYSON
  • NPI Number: 1437222957
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1042820
LAB Type Pharmacy
Facility Name KROGER PHARMACY 983
Street 17447 CAREY RD
City WESTFIELD
State IN
ZIP 46074
Phone 317 867-3022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Pharmacy
Lab Director HEATHER TYSON

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