36D1089935 CLIA NUMBER - KROGER PHARMACY #16591

Laboratory Demographics

  • CLIA Code: 36D1089935
  • Facility Name: KROGER PHARMACY #16591
  • Facility Address: 350 EAST BROAD STREET
    PATASKALA, OH
    ZIP 43062
  • Facility Phone: 740 964-5105
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF STECKMAN
  • NPI Number: 1861426579
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D1089935
LAB Type Pharmacy
Facility Name KROGER PHARMACY #16591
Street 350 EAST BROAD STREET
City PATASKALA
State OH
ZIP 43062
Phone 740 964-5105
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Pharmacy
Lab Director JEFF STECKMAN

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