36D2115048 CLIA NUMBER - KROGER PHARMACY 014-925

Laboratory Demographics

  • CLIA Code: 36D2115048
  • Facility Name: KROGER PHARMACY 014-925
  • Facility Address: 625 WEST CENTRAL AVE
    SPRINGBORO, OH
    ZIP 45066
  • Facility Phone: 937 514-7130
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE IZOR
  • NPI Number: 1841224540
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2115048
LAB Type Pharmacy
Facility Name KROGER PHARMACY 014-925
Street 625 WEST CENTRAL AVE
City SPRINGBORO
State OH
ZIP 45066
Phone 937 514-7130
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2024
Certificate Expiration Date 6/26/2026
Facility Type Pharmacy
Lab Director MICHELLE IZOR

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