45D1057297 CLIA NUMBER - KROGER PHARMACY 557

Laboratory Demographics

  • CLIA Code: 45D1057297
  • Facility Name: KROGER PHARMACY 557
  • Facility Address: 6850 NORTH SHILOH ROAD
    GARLAND, TX
    ZIP 75044
  • Facility Phone: 972 496-4503
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CINDIE DERBEN
  • NPI Number: 1801969118
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1057297
LAB Type Pharmacy
Facility Name KROGER PHARMACY 557
Street 6850 NORTH SHILOH ROAD
City GARLAND
State TX
ZIP 75044
Phone 972 496-4503
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Pharmacy
Lab Director CINDIE DERBEN

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