36D2039498 CLIA NUMBER - KROGER PHARMACY #741

Laboratory Demographics

  • CLIA Code: 36D2039498
  • Facility Name: KROGER PHARMACY #741
  • Facility Address: 2989 DERR ROAD
    SPRINGFIELD, OH
    ZIP 45503
  • Facility Phone: 937 390-0767
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1174548887
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2039498
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY #741
Street 2989 DERR ROAD
City SPRINGFIELD
State OH
ZIP 45503
Phone 937 390-0767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2024
Certificate Expiration Date 4/10/2026
Facility Type Other - RETAIL PHARMACY
Lab Director MICHELLE IZOR

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