45D1082310 CLIA NUMBER - KROGER PHARMACY 456

Laboratory Demographics

  • CLIA Code: 45D1082310
  • Facility Name: KROGER PHARMACY 456
  • Facility Address: 2709 CROSS TIMBERS ROAD
    FLOWER MOUND, TX
    ZIP 75028
  • Facility Phone: 972 355-1086
  • Facility Type: Industrial
  • Facility Type: Waiver
  • Lab Director: DENA BOYD
  • NPI Number: 1982612172
  • Taxonomy: 3336C0003X - Pharmacy

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2024
Certificate Expiration Date 4/3/2026
Facility Type Industrial
Lab Director DENA BOYD

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