45D1094857 CLIA NUMBER - KROGER PHARMACY 389

Laboratory Demographics

  • CLIA Code: 45D1094857
  • Facility Name: KROGER PHARMACY 389
  • Facility Address: 6616 FM 1488
    MAGNOLIA, TX
    ZIP 77355
  • Facility Phone: 936 321-9870
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEBORAH L. SHARP
  • NPI Number: 1760555296
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1094857
LAB Type Pharmacy
Facility Name KROGER PHARMACY 389
Street 6616 FM 1488
City MAGNOLIA
State TX
ZIP 77355
Phone 936 321-9870
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 DEBORAH L. SHARP

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