45D1063906 CLIA NUMBER - KROGER PHARMACY 518

Laboratory Demographics

  • CLIA Code: 45D1063906
  • Facility Name: KROGER PHARMACY 518
  • Facility Address: 5665 E MOCKINGBIRD
    DALLAS, TX
    ZIP 75206
  • Facility Phone: 214 826-2967
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE POHL
  • NPI Number: 1639242258
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D1063906
LAB Type Pharmacy
Facility Name KROGER PHARMACY 518
Street 5665 E MOCKINGBIRD
City DALLAS
State TX
ZIP 75206
Phone 214 826-2967
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 STEPHANIE POHL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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