36D2030438 CLIA NUMBER - KROGER PHARMACY #014-984

Laboratory Demographics

  • CLIA Code: 36D2030438
  • Facility Name: KROGER PHARMACY #014-984
  • Facility Address: 731 WEST MARKET STREET
    TROY, OH
    ZIP 45373
  • Facility Phone: 937 573-4530
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1932133733
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2030438
LAB Type Pharmacy
Facility Name KROGER PHARMACY #014-984
Street 731 WEST MARKET STREET
City TROY
State OH
ZIP 45373
Phone 937 573-4530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Pharmacy
Lab Director MICHELLE IZOR

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