36D2040920 CLIA NUMBER - KROGER PHARMACY 014-426

Laboratory Demographics

  • CLIA Code: 36D2040920
  • Facility Name: KROGER PHARMACY 014-426
  • Facility Address: 5210 STATE ROUTE 741
    MASON, OH
    ZIP 45040
  • Facility Phone: 513 398-8820
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1457385155
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2040920
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-426
Street 5210 STATE ROUTE 741
City MASON
State OH
ZIP 45040
Phone 513 398-8820
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