36D2030243 CLIA NUMBER - KROGER PHARMACY 014-832

Laboratory Demographics

  • CLIA Code: 36D2030243
  • Facility Name: KROGER PHARMACY 014-832
  • Facility Address: 965 N BECHTLE AVENUE
    SPRINGFIELD, OH
    ZIP 45504
  • Facility Phone: 937 323-0282
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1497789101
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2030243
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-832
Street 965 N BECHTLE AVENUE
City SPRINGFIELD
State OH
ZIP 45504
Phone 937 323-0282
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2025
Certificate Expiration Date 9/22/2027
Facility Type Pharmacy
Lab Director MICHELLE IZOR

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