36D1050210 CLIA NUMBER - KROGER PHARMACY 014-411

Laboratory Demographics

  • CLIA Code: 36D1050210
  • Facility Name: KROGER PHARMACY 014-411
  • Facility Address: 824 MAIN STREET
    MILFORD, OH
    ZIP 45150
  • Facility Phone: 513 831-4269
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1720003437
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D1050210
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-411
Street 824 MAIN STREET
City MILFORD
State OH
ZIP 45150
Phone 513 831-4269
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Pharmacy
Lab Director MICHELLE IZOR

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