18D2007629 CLIA NUMBER - KROGER PHARMACY 014-409

Laboratory Demographics

  • CLIA Code: 18D2007629
  • Facility Name: KROGER PHARMACY 014-409
  • Facility Address: 3105 NORTH BEND ROAD
    HEBRON, KY
    ZIP 41048
  • Facility Phone: 859 431-5413
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. MICHELLE IZOR
  • NPI Number: 1588698302
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 18D2007629
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-409
Street 3105 NORTH BEND ROAD
City HEBRON
State KY
ZIP 41048
Phone 859 431-5413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Pharmacy
Lab Director MS. MICHELLE IZOR

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