15D1076919 CLIA NUMBER - KROGER PHARMACY J981

Laboratory Demographics

  • CLIA Code: 15D1076919
  • Facility Name: KROGER PHARMACY J981
  • Facility Address: 2650 WABASH AVE
    TERRE HAUTE, IN
    ZIP 47803
  • Facility Phone: 812 235-7326
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANGITA R. PATEL
  • NPI Number: 1811060338
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1076919
LAB Type Pharmacy
Facility Name KROGER PHARMACY J981
Street 2650 WABASH AVE
City TERRE HAUTE
State IN
ZIP 47803
Phone 812 235-7326
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 SANGITA R. PATEL

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