45D1095386 CLIA NUMBER - KROGER PHARMACY 451

Laboratory Demographics

  • CLIA Code: 45D1095386
  • Facility Name: KROGER PHARMACY 451
  • Facility Address: 1060 N MAIN STREET
    EULESS, TX
    ZIP 76039
  • Facility Phone: 817 283-1152
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: NGOC PHAM
  • NPI Number: 1992878425
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1095386
LAB Type Independent
Facility Name KROGER PHARMACY 451
Street 1060 N MAIN STREET
City EULESS
State TX
ZIP 76039
Phone 817 283-1152
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 Independent
Lab Director NGOC PHAM

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