45D2001588 CLIA NUMBER - KROGER PHARMACY 492

Laboratory Demographics

  • CLIA Code: 45D2001588
  • Facility Name: KROGER PHARMACY 492
  • Facility Address: 11925 ELAM ROAD
    BALCH SPRINGS, TX
    ZIP 75180
  • Facility Phone: 972 557-2567
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHIRLEY GARRETT
  • NPI Number: 1568535177
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2001588
LAB Type Pharmacy
Facility Name KROGER PHARMACY 492
Street 11925 ELAM ROAD
City BALCH SPRINGS
State TX
ZIP 75180
Phone 972 557-2567
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 SHIRLEY GARRETT

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