45D2001889 CLIA NUMBER - KROGER PHARMACY 582

Laboratory Demographics

  • CLIA Code: 45D2001889
  • Facility Name: KROGER PHARMACY 582
  • Facility Address: 9135 BOULEVARD 26
    NORTH RICHLAND HILLS, TX
    ZIP 76180
  • Facility Phone: 817 605-3937
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STROUD BROWN
  • NPI Number: 1043383565
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2001889
LAB Type Pharmacy
Facility Name KROGER PHARMACY 582
Street 9135 BOULEVARD 26
City NORTH RICHLAND HILLS
State TX
ZIP 76180
Phone 817 605-3937
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Pharmacy
Lab Director STROUD BROWN

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