45D1067450 CLIA NUMBER - KROGER PHARMACY 136

Laboratory Demographics

  • CLIA Code: 45D1067450
  • Facility Name: KROGER PHARMACY 136
  • Facility Address: 341 S LOOP 336
    CONROE, TX
    ZIP 77304
  • Facility Phone: 936 270-1027
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TINA CHERIAN
  • NPI Number: 1689747107
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1067450
LAB Type Pharmacy
Facility Name KROGER PHARMACY 136
Street 341 S LOOP 336
City CONROE
State TX
ZIP 77304
Phone 936 270-1027
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/19/2025
Certificate Expiration Date 4/18/2027
Facility Type Pharmacy
Lab Director TINA CHERIAN

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