45D1095390 CLIA NUMBER - KROGER PHARMACY 495

Laboratory Demographics

  • CLIA Code: 45D1095390
  • Facility Name: KROGER PHARMACY 495
  • Facility Address: 515 S MACARTHUR BLVD
    IRVING, TX
    ZIP 75060
  • Facility Phone: 972 254-9105
  • Facility Type: Industrial
  • Facility Type: Waiver
  • Lab Director: TONY TRAN
  • NPI Number: 1295808814
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D1095390
LAB Type Industrial
Facility Name KROGER PHARMACY 495
Street 515 S MACARTHUR BLVD
City IRVING
State TX
ZIP 75060
Phone 972 254-9105
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 Industrial
Lab Director TONY TRAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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