45D2034925 CLIA NUMBER - KROGER PHARMACY #580

Laboratory Demographics

  • CLIA Code: 45D2034925
  • Facility Name: KROGER PHARMACY #580
  • Facility Address: 2671 LITTLE ELM PARKWAY
    LITTLE ELM, TX
    ZIP 75068
  • Facility Phone: 469 888-5519
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: GEORGE JONES
  • NPI Number: 1245523232
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2034925
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY #580
Street 2671 LITTLE ELM PARKWAY
City LITTLE ELM
State TX
ZIP 75068
Phone 469 888-5519
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2024
Certificate Expiration Date 1/5/2026
Facility Type Other - RETAIL PHARMACY
Lab Director GEORGE JONES

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