15D2005780 CLIA NUMBER - KROGER PHARMACY #998

Laboratory Demographics

  • CLIA Code: 15D2005780
  • Facility Name: KROGER PHARMACY #998
  • Facility Address: 1365 E 86TH ST
    INDIANAPOLIS, IN
    ZIP 46240
  • Facility Phone: 317 396-5230
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRYAN DALMAN
  • NPI Number: 1205068541
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2005780
LAB Type Pharmacy
Facility Name KROGER PHARMACY #998
Street 1365 E 86TH ST
City INDIANAPOLIS
State IN
ZIP 46240
Phone 317 396-5230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2024
Certificate Expiration Date 4/4/2026
Facility Type Pharmacy
Lab Director BRYAN DALMAN

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