36D2040369 CLIA NUMBER - KROGER PHARMACY #878

Laboratory Demographics

  • CLIA Code: 36D2040369
  • Facility Name: KROGER PHARMACY #878
  • Facility Address: 1094 NORTH MAIN STREET
    BOWLING GREEN, OH
    ZIP 43402
  • Facility Phone: 419 353-5116
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEVE BURSON
  • NPI Number: 1831123538
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2040369
LAB Type Pharmacy
Facility Name KROGER PHARMACY #878
Street 1094 NORTH MAIN STREET
City BOWLING GREEN
State OH
ZIP 43402
Phone 419 353-5116
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Pharmacy
Lab Director STEVE BURSON

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