45D1067429 CLIA NUMBER - KROGER PHARMACY 264

Laboratory Demographics

  • CLIA Code: 45D1067429
  • Facility Name: KROGER PHARMACY 264
  • Facility Address: 3245 EAST BROADWAY (FM 518)
    PEARLAND, TX
    ZIP 77581
  • Facility Phone: 281 485-1323
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIFFANY DANG
  • NPI Number: 1528131141
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1067429
LAB Type Pharmacy
Facility Name KROGER PHARMACY 264
Street 3245 EAST BROADWAY (FM 518)
City PEARLAND
State TX
ZIP 77581
Phone 281 485-1323
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2025
Certificate Expiration Date 4/17/2027
Facility Type Pharmacy
Lab Director TIFFANY DANG

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