15D1077191 CLIA NUMBER - KROGER PHARMACY J-985

Laboratory Demographics

  • CLIA Code: 15D1077191
  • Facility Name: KROGER PHARMACY J-985
  • Facility Address: 108 N SR 267
    AVON, IN
    ZIP 46123
  • Facility Phone: 317 272-4135
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES P. LONE
  • NPI Number: 1801969324
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1077191
LAB Type Pharmacy
Facility Name KROGER PHARMACY J-985
Street 108 N SR 267
City AVON
State IN
ZIP 46123
Phone 317 272-4135
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Pharmacy
Lab Director JAMES P. LONE

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