19D2130174 CLIA NUMBER - KROGER PHARMACY #34-394

Laboratory Demographics

  • CLIA Code: 19D2130174
  • Facility Name: KROGER PHARMACY #34-394
  • Facility Address: 2010 COUNTRY CLUB RD
    LAKE CHARLES, LA
    ZIP 70605
  • Facility Phone: 713 507-6276
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELIZABETH MCDANIEL
  • NPI Number: 1861872665
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 19D2130174
LAB Type Pharmacy
Facility Name KROGER PHARMACY #34-394
Street 2010 COUNTRY CLUB RD
City LAKE CHARLES
State LA
ZIP 70605
Phone 713 507-6276
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Pharmacy
Lab Director ELIZABETH MCDANIEL

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