45D1095382 CLIA NUMBER - KROGER PHARMACY 191

Laboratory Demographics

  • CLIA Code: 45D1095382
  • Facility Name: KROGER PHARMACY 191
  • Facility Address: 313 EAST SPUR 303
    GRAND PRAIRIE, TX
    ZIP 75051
  • Facility Phone: 972 264-3011
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNY A. GALINDO
  • NPI Number: 1699848911
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1095382
LAB Type Pharmacy
Facility Name KROGER PHARMACY 191
Street 313 EAST SPUR 303
City GRAND PRAIRIE
State TX
ZIP 75051
Phone 972 264-3011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2025
Certificate Expiration Date 2/5/2027
Facility Type Pharmacy
Lab Director JENNY A. GALINDO

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