15D2093627 CLIA NUMBER - KROGER PHARMACY #991

Laboratory Demographics

  • CLIA Code: 15D2093627
  • Facility Name: KROGER PHARMACY #991
  • Facility Address: 1005 W 7TH ST
    AUBURN, IN
    ZIP 46706
  • Facility Phone: 260 920-2170
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN TRACEY
  • NPI Number: 1538232053
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2093627
LAB Type Pharmacy
Facility Name KROGER PHARMACY #991
Street 1005 W 7TH ST
City AUBURN
State IN
ZIP 46706
Phone 260 920-2170
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 RYAN TRACEY

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