23D2027762 CLIA NUMBER - KROGER PHARMACY

Laboratory Demographics

  • CLIA Code: 23D2027762
  • Facility Name: KROGER PHARMACY
  • Facility Address: 700 N STATE STREET KROGER PHARMACY 018-714 ATTN PHARMACIST IN CHARGE
    DAVISON, MI
    ZIP 48423
  • Facility Phone: 810 658-8051
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT BROWN
  • NPI Number: 1720012594
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2027762
LAB Type Pharmacy
Facility Name KROGER PHARMACY
Street 700 N STATE STREET KROGER PHARMACY 018-714 ATTN PHARMACIST IN CHARGE
City DAVISON
State MI
ZIP 48423
Phone 810 658-8051
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2023
Certificate Expiration Date 7/31/2025
Facility Type Pharmacy
Lab Director ROBERT BROWN

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This page was last updated on: 6/4/2025