36D2030247 CLIA NUMBER - KROGER PHARMACY 014-920

Laboratory Demographics

  • CLIA Code: 36D2030247
  • Facility Name: KROGER PHARMACY 014-920
  • Facility Address: 210 STERLING RUN BLVD
    MOUNT ORAB, OH
    ZIP 45154
  • Facility Phone: 937 444-5014
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1043244759
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2030247
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-920
Street 210 STERLING RUN BLVD
City MOUNT ORAB
State OH
ZIP 45154
Phone 937 444-5014
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

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