45D2061315 CLIA NUMBER - KROGER PHARMACY #578

Laboratory Demographics

  • CLIA Code: 45D2061315
  • Facility Name: KROGER PHARMACY #578
  • Facility Address: 2608 W FM 544
    WYLIE, TX
    ZIP 75098
  • Facility Phone: 972 244-7681
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: JEFF LOESCH
  • NPI Number: 1285976142
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2061315
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY #578
Street 2608 W FM 544
City WYLIE
State TX
ZIP 75098
Phone 972 244-7681
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type Other - RETAIL PHARMACY
Lab Director JEFF LOESCH

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