36D1093625 CLIA NUMBER - KROGER PHARMACY 014-447

Laboratory Demographics

  • CLIA Code: 36D1093625
  • Facility Name: KROGER PHARMACY 014-447
  • Facility Address: 1425 COLUMBUS AVENUE
    LEBANON, OH
    ZIP 45036
  • Facility Phone: 513 228-7370
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1093749798
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D1093625
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-447
Street 1425 COLUMBUS AVENUE
City LEBANON
State OH
ZIP 45036
Phone 513 228-7370
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/24/2024
Certificate Expiration Date 12/23/2026
Facility Type Pharmacy
Lab Director MICHELLE IZOR

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