45D1058731 CLIA NUMBER - KROGER PHARMACY 361

Laboratory Demographics

  • CLIA Code: 45D1058731
  • Facility Name: KROGER PHARMACY 361
  • Facility Address: 3535 LONGMIRE DR
    COLLEGE STATION, TX
    ZIP 77845
  • Facility Phone: 979 485-8813
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SARA L. CARROLL
  • NPI Number: 1962575480
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1058731
LAB Type Pharmacy
Facility Name KROGER PHARMACY 361
Street 3535 LONGMIRE DR
City COLLEGE STATION
State TX
ZIP 77845
Phone 979 485-8813
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Pharmacy
Lab Director SARA L. CARROLL

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