15D1076918 CLIA NUMBER - KROGER PHARMACY J71

Laboratory Demographics

  • CLIA Code: 15D1076918
  • Facility Name: KROGER PHARMACY J71
  • Facility Address: 2821 S WASHINGTON
    KOKOMO, IN
    ZIP 46902
  • Facility Phone: 765 453-3173
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LEE BARKER
  • NPI Number: 1548333065
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1076918
LAB Type Pharmacy
Facility Name KROGER PHARMACY J71
Street 2821 S WASHINGTON
City KOKOMO
State IN
ZIP 46902
Phone 765 453-3173
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 LEE BARKER

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