36D1092124 CLIA NUMBER - KROGER PHARMACY #363

Laboratory Demographics

  • CLIA Code: 36D1092124
  • Facility Name: KROGER PHARMACY #363
  • Facility Address: 220 WAVERLY PLAZA
    WAVERLY, OH
    ZIP 45690
  • Facility Phone: 740 947-0128
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF STECKMAN
  • NPI Number: 1417981127
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D1092124
LAB Type Pharmacy
Facility Name KROGER PHARMACY #363
Street 220 WAVERLY PLAZA
City WAVERLY
State OH
ZIP 45690
Phone 740 947-0128
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2024
Certificate Expiration Date 11/17/2026
Facility Type Pharmacy
Lab Director JEFF STECKMAN

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