45D1094819 CLIA NUMBER - KROGER PHARMACY 307

Laboratory Demographics

  • CLIA Code: 45D1094819
  • Facility Name: KROGER PHARMACY 307
  • Facility Address: 15802 CHAMPION FOREST DR
    SPRING, TX
    ZIP 77379
  • Facility Phone: 281 370-9481
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRACEY NGUYEN
  • NPI Number: 1558434175
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1094819
LAB Type Pharmacy
Facility Name KROGER PHARMACY 307
Street 15802 CHAMPION FOREST DR
City SPRING
State TX
ZIP 77379
Phone 281 370-9481
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 TRACEY NGUYEN

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