45D1067627 CLIA NUMBER - KROGER PHARMACY 460

Laboratory Demographics

  • CLIA Code: 45D1067627
  • Facility Name: KROGER PHARMACY 460
  • Facility Address: 4038 OLD DENTON ROAD
    CARROLLTON, TX
    ZIP 75007
  • Facility Phone: 972 512-3366
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN HAND
  • NPI Number: 1124052865
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D1067627
LAB Type Pharmacy
Facility Name KROGER PHARMACY 460
Street 4038 OLD DENTON ROAD
City CARROLLTON
State TX
ZIP 75007
Phone 972 512-3366
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Pharmacy
Lab Director RYAN HAND

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