45D2001554 CLIA NUMBER - KROGER PHARMACY 213

Laboratory Demographics

  • CLIA Code: 45D2001554
  • Facility Name: KROGER PHARMACY 213
  • Facility Address: 752 WYNNEWOOD VILLAGE
    DALLAS, TX
    ZIP 75224
  • Facility Phone: 214 942-3191
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF LOESCH
  • NPI Number: 1013080332
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2001554
LAB Type Pharmacy
Facility Name KROGER PHARMACY 213
Street 752 WYNNEWOOD VILLAGE
City DALLAS
State TX
ZIP 75224
Phone 214 942-3191
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2023
Certificate Expiration Date 12/21/2025
Facility Type Pharmacy
Lab Director JEFF LOESCH

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