45D2001569 CLIA NUMBER - KROGER PHARMACY 415

Laboratory Demographics

  • CLIA Code: 45D2001569
  • Facility Name: KROGER PHARMACY 415
  • Facility Address: 1617 W HENDERSON
    CLEBURNE, TX
    ZIP 76033
  • Facility Phone: 817 641-0700
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF LOESCH
  • NPI Number: 1740353366
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2001569
LAB Type Pharmacy
Facility Name KROGER PHARMACY 415
Street 1617 W HENDERSON
City CLEBURNE
State TX
ZIP 76033
Phone 817 641-0700
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