23D2076997 CLIA NUMBER - KROGER CO OF MICHIGAN, THE

Laboratory Demographics

  • CLIA Code: 23D2076997
  • Facility Name: KROGER CO OF MICHIGAN, THE
  • Facility Address: 3097 S BALDWIN ROAD KROGER PHARMACY 018-649 ATTN PHARMACIST IN CHARGE
    ORION, MI
    ZIP 48360
  • Facility Phone: 248 393-4573
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: ROBERT BROWN
  • NPI Number: 1689608457
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2076997
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER CO OF MICHIGAN, THE
Street 3097 S BALDWIN ROAD KROGER PHARMACY 018-649 ATTN PHARMACIST IN CHARGE
City ORION
State MI
ZIP 48360
Phone 248 393-4573
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Other - RETAIL PHARMACY
Lab Director ROBERT BROWN

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