45D1057966 CLIA NUMBER - KROGER PHARMACY 516

Laboratory Demographics

  • CLIA Code: 45D1057966
  • Facility Name: KROGER PHARMACY 516
  • Facility Address: 976 PRICE (HWY 1709)
    KELLER, TX
    ZIP 76248
  • Facility Phone: 817 431-5178
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID SANDERS
  • NPI Number: 1689747909
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1057966
LAB Type Pharmacy
Facility Name KROGER PHARMACY 516
Street 976 PRICE (HWY 1709)
City KELLER
State TX
ZIP 76248
Phone 817 431-5178
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Pharmacy
Lab Director DAVID SANDERS

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