15D2143465 CLIA NUMBER - KROGER PHARMACY #21-339

Laboratory Demographics

  • CLIA Code: 15D2143465
  • Facility Name: KROGER PHARMACY #21-339
  • Facility Address: 227 W MICHIGAN ST
    INDIANAPOLIS, IN
    ZIP 46204
  • Facility Phone: 317 262-5267
  • Facility Type: Other - PHARMACY
  • Facility Type: Waiver
  • Lab Director: ALLYSON DINN
  • NPI Number: 1649783432
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2143465
LAB Type Other - PHARMACY
Facility Name KROGER PHARMACY #21-339
Street 227 W MICHIGAN ST
City INDIANAPOLIS
State IN
ZIP 46204
Phone 317 262-5267
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Other - PHARMACY
Lab Director ALLYSON DINN

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