45D1057171 CLIA NUMBER - KROGER PHARMACY 445

Laboratory Demographics

  • CLIA Code: 45D1057171
  • Facility Name: KROGER PHARMACY 445
  • Facility Address: 5330 S COOPER
    ARLINGTON, TX
    ZIP 76017
  • Facility Phone: 817 472-9576
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHAUNEEN CAIN
  • NPI Number: 1821161449
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1057171
LAB Type Pharmacy
Facility Name KROGER PHARMACY 445
Street 5330 S COOPER
City ARLINGTON
State TX
ZIP 76017
Phone 817 472-9576
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2024
Certificate Expiration Date 8/3/2026
Facility Type Pharmacy
Lab Director SHAUNEEN CAIN

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