15D1077800 CLIA NUMBER - KROGER PHARMACY J-957

Laboratory Demographics

  • CLIA Code: 15D1077800
  • Facility Name: KROGER PHARMACY J-957
  • Facility Address: 172 W LOGAN ST
    NOBLESVILLE, IN
    ZIP 46060
  • Facility Phone: (317) 776-3347
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE I. BERDING
  • NPI Number: 1023181542
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D1077800
LAB Type Pharmacy
Facility Name KROGER PHARMACY J-957
Street 172 W LOGAN ST
City NOBLESVILLE
State IN
ZIP 46060
Phone 3177763347
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2025
Certificate Expiration Date 12/18/2027
Facility Type Pharmacy
Lab Director MICHELLE I. BERDING

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This page was last updated on: 5/18/2026