45D1005290 CLIA NUMBER - KROGER PHARMACY #325

Laboratory Demographics

  • CLIA Code: 45D1005290
  • Facility Name: KROGER PHARMACY #325
  • Facility Address: 3965 DOWLEN ATTN PHARMACY
    BEAUMONT, TX
    ZIP 77706
  • Facility Phone: 409 899-8697
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DARON STREDIC
  • NPI Number: 1134292659
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1005290
LAB Type Pharmacy
Facility Name KROGER PHARMACY #325
Street 3965 DOWLEN ATTN PHARMACY
City BEAUMONT
State TX
ZIP 77706
Phone 409 899-8697
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2024
Certificate Expiration Date 10/16/2026
Facility Type Pharmacy
Lab Director DARON STREDIC

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