36D2040918 CLIA NUMBER - KROGER PHARMACY 014-335

Laboratory Demographics

  • CLIA Code: 36D2040918
  • Facility Name: KROGER PHARMACY 014-335
  • Facility Address: 428 OXFORD STATE ROAD
    MIDDLETOWN, OH
    ZIP 45044
  • Facility Phone: 513 423-7097
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1326072075
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2040918
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-335
Street 428 OXFORD STATE ROAD
City MIDDLETOWN
State OH
ZIP 45044
Phone 513 423-7097
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2024
Certificate Expiration Date 5/10/2026
Facility Type Pharmacy
Lab Director MICHELLE IZOR

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