36D2039670 CLIA NUMBER - KROGER PHARMACY 014-765

Laboratory Demographics

  • CLIA Code: 36D2039670
  • Facility Name: KROGER PHARMACY 014-765
  • Facility Address: 601 WOODMAN DR
    DAYTON, OH
    ZIP 45431
  • Facility Phone: (937) 535-5820
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1326072125
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2039670
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-765
Street 601 WOODMAN DR
City DAYTON
State OH
ZIP 45431
Phone 9375355820
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2026
Certificate Expiration Date 4/15/2028
Facility Type Pharmacy
Lab Director MICHELLE IZOR

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This page was last updated on: 5/18/2026