15D1076881 CLIA NUMBER - KROGER PHARMACY 857

Laboratory Demographics

  • CLIA Code: 15D1076881
  • Facility Name: KROGER PHARMACY 857
  • Facility Address: 821 LINCOLN HIGHWAY WEST
    NEW HAVEN, IN
    ZIP 46774
  • Facility Phone: 260 749-0215
  • Facility Type: Other - PHARMACY
  • Facility Type: Waiver
  • Lab Director: ANDREA PANYARD
  • NPI Number: 1376616896
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1076881
LAB Type Other - PHARMACY
Facility Name KROGER PHARMACY 857
Street 821 LINCOLN HIGHWAY WEST
City NEW HAVEN
State IN
ZIP 46774
Phone 260 749-0215
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2023
Certificate Expiration Date 11/26/2025
Facility Type Other - PHARMACY
Lab Director ANDREA PANYARD

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