36D1070450 CLIA NUMBER - KROGER PHARMACY 014-395

Laboratory Demographics

  • CLIA Code: 36D1070450
  • Facility Name: KROGER PHARMACY 014-395
  • Facility Address: 1001 CHERRY STREET, SUITE A
    BLANCHESTER, OH
    ZIP 45107
  • Facility Phone: 937 783-0270
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1427113695
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D1070450
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-395
Street 1001 CHERRY STREET, SUITE A
City BLANCHESTER
State OH
ZIP 45107
Phone 937 783-0270
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2025
Certificate Expiration Date 8/22/2027
Facility Type Pharmacy
Lab Director MICHELLE IZOR

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