45D2008528 CLIA NUMBER - KROGER PHARMACY 520

Laboratory Demographics

  • CLIA Code: 45D2008528
  • Facility Name: KROGER PHARMACY 520
  • Facility Address: 3120 S UNIVERSITY
    FORT WORTH, TX
    ZIP 76109
  • Facility Phone: 817 566-7861
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LEIGH GARRISON
  • NPI Number: 1225352230
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2008528
LAB Type Pharmacy
Facility Name KROGER PHARMACY 520
Street 3120 S UNIVERSITY
City FORT WORTH
State TX
ZIP 76109
Phone 817 566-7861
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Pharmacy
Lab Director LEIGH GARRISON

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