45D1068169 CLIA NUMBER - KROGER PHARMACY #511

Laboratory Demographics

  • CLIA Code: 45D1068169
  • Facility Name: KROGER PHARMACY #511
  • Facility Address: 10677 E NORTHWEST HIGHWAY
    DALLAS, TX
    ZIP 75238
  • Facility Phone: 214 553-0997
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF LOESCH
  • NPI Number: 1730252354
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1068169
LAB Type Pharmacy
Facility Name KROGER PHARMACY #511
Street 10677 E NORTHWEST HIGHWAY
City DALLAS
State TX
ZIP 75238
Phone 214 553-0997
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2025
Certificate Expiration Date 5/8/2027
Facility Type Pharmacy
Lab Director JEFF LOESCH

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