45D1057189 CLIA NUMBER - KROGER PHARMACY 527

Laboratory Demographics

  • CLIA Code: 45D1057189
  • Facility Name: KROGER PHARMACY 527
  • Facility Address: 200 W CAMP WISDOM ROAD
    DUNCANVILLE, TX
    ZIP 75116
  • Facility Phone: 972 298-6255
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANOSIKE PASCAL
  • NPI Number: 1568535094
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D1057189
LAB Type Pharmacy
Facility Name KROGER PHARMACY 527
Street 200 W CAMP WISDOM ROAD
City DUNCANVILLE
State TX
ZIP 75116
Phone 972 298-6255
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 ANOSIKE PASCAL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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