15D1077272 CLIA NUMBER - KROGER PHARMACY 911

Laboratory Demographics

  • CLIA Code: 15D1077272
  • Facility Name: KROGER PHARMACY 911
  • Facility Address: 2140 FT HARRISON RD
    TERRE HAUTE, IN
    ZIP 47805
  • Facility Phone: 812 466-6545
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASHLEY SULLIVAN
  • NPI Number: 1043383664
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1077272
LAB Type Pharmacy
Facility Name KROGER PHARMACY 911
Street 2140 FT HARRISON RD
City TERRE HAUTE
State IN
ZIP 47805
Phone 812 466-6545
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Pharmacy
Lab Director ASHLEY SULLIVAN

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