45D1058732 CLIA NUMBER - KROGER PHARMACY 328

Laboratory Demographics

  • CLIA Code: 45D1058732
  • Facility Name: KROGER PHARMACY 328
  • Facility Address: 3845 PHELAN
    BEAUMONT, TX
    ZIP 77707
  • Facility Phone: 409 833-4437
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY MANUEL
  • NPI Number: 1275606709
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1058732
LAB Type Pharmacy
Facility Name KROGER PHARMACY 328
Street 3845 PHELAN
City BEAUMONT
State TX
ZIP 77707
Phone 409 833-4437
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 AMY MANUEL

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This page was last updated on: 6/4/2025