36D2003804 CLIA NUMBER - KROGER PHARMACY #016518

Laboratory Demographics

  • CLIA Code: 36D2003804
  • Facility Name: KROGER PHARMACY #016518
  • Facility Address: 1240 PARK AVENUE WEST
    MANSFIELD, OH
    ZIP 44906
  • Facility Phone: 419 528-1862
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF STECKMAN
  • NPI Number: 1376577098
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2003804
LAB Type Pharmacy
Facility Name KROGER PHARMACY #016518
Street 1240 PARK AVENUE WEST
City MANSFIELD
State OH
ZIP 44906
Phone 419 528-1862
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2024
Certificate Expiration Date 2/17/2026
Facility Type Pharmacy
Lab Director JEFF STECKMAN

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