CLIA lab
CLIA 15D2093590: Kroger Pharmacy #425
Ft Wayne, IN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 15D2093590 belongs to Kroger Pharmacy #425 in Ft Wayne, 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
- March 31, 2015
- 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
- 15D2093590
- Lab name
- Kroger Pharmacy #425
- Address
- 6310 E State Blvd, Ft Wayne, IN 46815
- Phone
- (260) 493-1531
- Fax
- (260) 493-0987
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.
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- Fort Wayne Vascular Care, LLCCertificate of Waiver, Ambulatory surgery center15D2164630
- Fort Wayne on the Go Mobile Drug & AlcoholCertificate of Waiver, Mobile lab15D2319515
- Fresenius Medical Care Fort Wayne JeffersonCertificate of Waiver, End stage renal disease dialysis facility15D0647525
- Great Lakes Caring Hospice Nin, LLC DBA ElaraCertificate of Waiver, Hospice15D2330740
- Holy Family Birth CenterCertificate of Waiver, Other15D2168308
- Iuhmg Riley SpecialistsCertificate of Waiver, Physician office15D2141694
- Karim Moshref MD PCCertificate for Provider-Performed Microscopy Procedures, Physician office15D0975862
- M Teresa Tallon MDCertificate of Waiver, Physician office15D0678780
Related
Questions
What is the CLIA number for Kroger Pharmacy #425 in Ft Wayne?
15D2093590, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kroger Pharmacy #425 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 15D2093590 expire?
The CMS file lists March 30, 2027 as the certificate expiration date; the certificate took effect March 31, 2025.