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45D1082310 CLIA NUMBER - KROGER PHARMACY 456

Laboratory Demographics

CLIA Number: 45D1082310

Facility Name: KROGER PHARMACY 456

Facility Address:
2709 CROSS TIMBERS ROAD
FLOWER MOUND, TX
ZIP 75028
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Facility Phone Number: 972 355-1086

Facility Type: Industrial

Certificate Type: Waiver
NPI Number: 1982612172

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 45D1082310
LAB Type Industrial
Facility Name KROGER PHARMACY 456
Street 2709 CROSS TIMBERS ROAD
City FLOWER MOUND
State TX
ZIP 75028
Phone 972 355-1086
CertificateType 4
CertificateEffectiveDate 4/4/2024
CertificateExpirationDate 4/3/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024