15D1076913 CLIA NUMBER - KROGER PHARMACY J-987

Laboratory Demographics

  • CLIA Code: 15D1076913
  • Facility Name: KROGER PHARMACY J-987
  • Facility Address: 4714 S US HWY 41
    TERRE HAUTE, IN
    ZIP 47802
  • Facility Phone: 812 232-8379
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENISH PATEL
  • NPI Number: 1952474579
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1076913
LAB Type Pharmacy
Facility Name KROGER PHARMACY J-987
Street 4714 S US HWY 41
City TERRE HAUTE
State IN
ZIP 47802
Phone 812 232-8379
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2023
Certificate Expiration Date 11/27/2025
Facility Type Pharmacy
Lab Director JENISH PATEL

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