45D2001559 CLIA NUMBER - KROGER PHARMACY 402

Laboratory Demographics

  • CLIA Code: 45D2001559
  • Facility Name: KROGER PHARMACY 402
  • Facility Address: 3612 N BELTLINE ROAD
    IRVING, TX
    ZIP 75062
  • Facility Phone: 972 252-6450
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF LOESCH
  • NPI Number: 1093888521
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2001559
LAB Type Pharmacy
Facility Name KROGER PHARMACY 402
Street 3612 N BELTLINE ROAD
City IRVING
State TX
ZIP 75062
Phone 972 252-6450
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

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