36D1027760 CLIA NUMBER - KROGER PHARMACY 014-902

Laboratory Demographics

  • CLIA Code: 36D1027760
  • Facility Name: KROGER PHARMACY 014-902
  • Facility Address: 4530 EASTGATE BLVD
    CINCINNATI, OH
    ZIP 45245
  • Facility Phone: 513 943-6340
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1114951910
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D1027760
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-902
Street 4530 EASTGATE BLVD
City CINCINNATI
State OH
ZIP 45245
Phone 513 943-6340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2024
Certificate Expiration Date 7/8/2026
Facility Type Pharmacy
Lab Director MICHELLE IZOR

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