36D1093669 CLIA NUMBER - KROGER PHARMACY #781

Laboratory Demographics

  • CLIA Code: 36D1093669
  • Facility Name: KROGER PHARMACY #781
  • Facility Address: 6306 COUNTY RD 107
    PROCTORVILLE, OH
    ZIP 45669
  • Facility Phone: 740 886-7146
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRIS KOON
  • NPI Number: 1619901410
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D1093669
LAB Type Pharmacy
Facility Name KROGER PHARMACY #781
Street 6306 COUNTY RD 107
City PROCTORVILLE
State OH
ZIP 45669
Phone 740 886-7146
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Pharmacy
Lab Director CHRIS KOON

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