CLIA lab
CLIA 15D1006754: Kroger Pharmacy #879
Goshen, IN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 15D1006754 belongs to Kroger Pharmacy #879 in Goshen, IN.
Certificate of Waiver, effective March 31, 2025, expires March 30, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- March 31, 2025
- Certificate expiration
- March 30, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 27, 2002
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 15D1006754
- Lab name
- Kroger Pharmacy #879
- Address
- 209 Chicago Ave, Goshen, IN 46526
- Phone
- (574) 534-9223
- Fax
- (574) 533-0804
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Goshen, IN
- Advent GoshenCertificate of Waiver, Physician office15D2308350
- Bashor Home of the United Methodist Church IncCertificate of Waiver, Other15D2227095
- Beacon Goshen Outpatient Center-Beacon ImagingCertificate of Waiver, Independent15D2253566
- Beacon Medical Group - GoshenCertificate for Provider-Performed Microscopy Procedures, Physician office15D0955447
- Beacon Medical Group Pediatrics GoshenCertificate of Waiver, Physician office15D2019223
- Beacon Medical Group Specialists GoshenCertificate of Waiver, Physician office15D2246478
- Beacon Medical Group Urology GoshenCertificate of Waiver, Physician office15D2315648
- Beacon Medical Grp-GoshenCertificate for Provider-Performed Microscopy Procedures, Physician office15D0927647
- Beacon Occupational Health, LLCCertificate of Waiver, Industrial15D2009600
- Center for Healing & HopeCertificate for Provider-Performed Microscopy Procedures, Community clinic15D2164421
Related
Questions
What is the CLIA number for Kroger Pharmacy #879 in Goshen?
15D1006754, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kroger Pharmacy #879 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 15D1006754 expire?
The CMS file lists March 30, 2027 as the certificate expiration date; the certificate took effect March 31, 2025.