45D2000771 CLIA NUMBER - KROGER PHARMACY 959

Laboratory Demographics

  • CLIA Code: 45D2000771
  • Facility Name: KROGER PHARMACY 959
  • Facility Address: 701 W MARSHALL
    LONGVIEW, TX
    ZIP 75601
  • Facility Phone: 903 758-0323
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF LOESCH
  • NPI Number: 1477626901
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2000771
LAB Type Pharmacy
Facility Name KROGER PHARMACY 959
Street 701 W MARSHALL
City LONGVIEW
State TX
ZIP 75601
Phone 903 758-0323
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Pharmacy
Lab Director JEFF LOESCH

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