36D2060477 CLIA NUMBER - KROGER PHARMACY 014-405

Laboratory Demographics

  • CLIA Code: 36D2060477
  • Facility Name: KROGER PHARMACY 014-405
  • Facility Address: 8241 VINE ST PHARMACIST IN CHARGE
    CINCINNATI, OH
    ZIP 45216
  • Facility Phone: 513 821-9660
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1922032721
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2060477
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-405
Street 8241 VINE ST PHARMACIST IN CHARGE
City CINCINNATI
State OH
ZIP 45216
Phone 513 821-9660
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Pharmacy
Lab Director MICHELLE IZOR

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