36D1078180 CLIA NUMBER - KROGER PHARMACY #936

Laboratory Demographics

  • CLIA Code: 36D1078180
  • Facility Name: KROGER PHARMACY #936
  • Facility Address: 1890 EAST 2ND STREET
    DEFIANCE, OH
    ZIP 43512
  • Facility Phone: 419 782-8079
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER E. LAYNE
  • NPI Number: 1427121946
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D1078180
LAB Type Pharmacy
Facility Name KROGER PHARMACY #936
Street 1890 EAST 2ND STREET
City DEFIANCE
State OH
ZIP 43512
Phone 419 782-8079
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Pharmacy
Lab Director JENNIFER E. LAYNE

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