45D1063903 CLIA NUMBER - KROGER PHARMACY 224

Laboratory Demographics

  • CLIA Code: 45D1063903
  • Facility Name: KROGER PHARMACY 224
  • Facility Address: 3510 ALTA MESA
    FORT WORTH, TX
    ZIP 76133
  • Facility Phone: 817 292-3777
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAREN G. LARRY
  • NPI Number: 1295808723
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1063903
LAB Type Pharmacy
Facility Name KROGER PHARMACY 224
Street 3510 ALTA MESA
City FORT WORTH
State TX
ZIP 76133
Phone 817 292-3777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Pharmacy
Lab Director KAREN G. LARRY

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