18D1077163 CLIA NUMBER - KROGER PHARMACY #392

Laboratory Demographics

  • CLIA Code: 18D1077163
  • Facility Name: KROGER PHARMACY #392
  • Facility Address: 4303 WINSTON AVENUE
    LATONIA, KY
    ZIP 41015
  • Facility Phone: 859 655-0720
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: MS. MICHELLE IZOR
  • NPI Number: 1851325617
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D1077163
LAB Type Other
Facility Name KROGER PHARMACY #392
Street 4303 WINSTON AVENUE
City LATONIA
State KY
ZIP 41015
Phone 859 655-0720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Other
Lab Director MS. MICHELLE IZOR

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