45D1094817 CLIA NUMBER - KROGER PHARMACY 149

Laboratory Demographics

  • CLIA Code: 45D1094817
  • Facility Name: KROGER PHARMACY 149
  • Facility Address: 800 N DIXIE DRIVE
    CLUTE, TX
    ZIP 77531
  • Facility Phone: 979 265-5219
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HAO TAU
  • NPI Number: 1649343179
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1094817
LAB Type Pharmacy
Facility Name KROGER PHARMACY 149
Street 800 N DIXIE DRIVE
City CLUTE
State TX
ZIP 77531
Phone 979 265-5219
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Pharmacy
Lab Director HAO TAU

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