36D2112414 CLIA NUMBER - KROGER PHARMACY

Laboratory Demographics

  • CLIA Code: 36D2112414
  • Facility Name: KROGER PHARMACY
  • Facility Address: 400 28TH STREET
    BELLAIRE, OH
    ZIP 43906
  • Facility Phone: 740 671-5169
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEVE BURSON
  • NPI Number: 1053345751
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2112414
LAB Type Pharmacy
Facility Name KROGER PHARMACY
Street 400 28TH STREET
City BELLAIRE
State OH
ZIP 43906
Phone 740 671-5169
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2024
Certificate Expiration Date 4/27/2026
Facility Type Pharmacy
Lab Director STEVE BURSON

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