CLIA lab
CLIA 15D1077255: Kroger Pharmacy 00874
Columbia City, IN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 15D1077255 belongs to Kroger Pharmacy 00874 in Columbia City, 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
- December 5, 2007
- 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
- 15D1077255
- Lab name
- Kroger Pharmacy 00874
- Address
- 621 Countryside Dr, Columbia City, IN 46725
- Phone
- (260) 248-4572
- Fax
- (260) 248-4573
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 Columbia City, IN
- Bowen Health Clinic - Columbia CityCertificate of Waiver, Federally qualified health center15D2297147
- CarlyleCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities15D2316856
- Columbia City OptometryCertificate of Waiver, Other practitioner15D2178827
- David C Lieb MDCertificate of Waiver, Physician office15D1043331
- Miller's at Oak PointeCertificate of Waiver, Skilled nursing or nursing facility15D0357658
- PPG - Family Medicine, Whitley MopCertificate of Waiver, Physician office15D1080968
- PPG Columbia City Ste 220Certificate of Waiver, Physician office15D0968886
- PPG Obgyn WhitleyCertificate for Provider-Performed Microscopy Procedures, Physician office15D0987489
- PPG Urology Columbia CityCertificate of Waiver, Physician office15D2021556
- Parkview Columbia City Pain ManagementCertificate of Waiver, Physician office15D2176796
Related
Questions
What is the CLIA number for Kroger Pharmacy 00874 in Columbia City?
15D1077255, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kroger Pharmacy 00874 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 15D1077255 expire?
The CMS file lists March 30, 2027 as the certificate expiration date; the certificate took effect March 31, 2025.