45D1057148 CLIA NUMBER - KROGER PHARMACY 320

Laboratory Demographics

  • CLIA Code: 45D1057148
  • Facility Name: KROGER PHARMACY 320
  • Facility Address: 4825 SWEETWATER BLVD
    SUGAR LAND, TX
    ZIP 77479
  • Facility Phone: 281 494-6555
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON MOODY
  • NPI Number: 1245303767
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1057148
LAB Type Pharmacy
Facility Name KROGER PHARMACY 320
Street 4825 SWEETWATER BLVD
City SUGAR LAND
State TX
ZIP 77479
Phone 281 494-6555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2024
Certificate Expiration Date 8/2/2026
Facility Type Pharmacy
Lab Director BRANDON MOODY

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