23D2113939 CLIA NUMBER - KROGER PHARMACY #864

Laboratory Demographics

  • CLIA Code: 23D2113939
  • Facility Name: KROGER PHARMACY #864
  • Facility Address: 3462 W STERNS ROAD
    LAMBERTVILLE, MI
    ZIP 48144
  • Facility Phone: 734 854-2690
  • Facility Type: Other - PHARMACY
  • Facility Type: Waiver
  • Lab Director: STEVE BURSON
  • NPI Number: 1083648836
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2113939
LAB Type Other - PHARMACY
Facility Name KROGER PHARMACY #864
Street 3462 W STERNS ROAD
City LAMBERTVILLE
State MI
ZIP 48144
Phone 734 854-2690
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Other - PHARMACY
Lab Director STEVE BURSON

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