36D2030245 CLIA NUMBER - KROGER PHARMACY #913

Laboratory Demographics

  • CLIA Code: 36D2030245
  • Facility Name: KROGER PHARMACY #913
  • Facility Address: 2100 WEST MICHIGAN STREET
    SIDNEY, OH
    ZIP 45365
  • Facility Phone: 937 498-4116
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1548294242
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2030245
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY #913
Street 2100 WEST MICHIGAN STREET
City SIDNEY
State OH
ZIP 45365
Phone 937 498-4116
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 Other - RETAIL PHARMACY
Lab Director MICHELLE IZOR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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