45D2075527 CLIA NUMBER - KROGER PHARMACY #117

Laboratory Demographics

  • CLIA Code: 45D2075527
  • Facility Name: KROGER PHARMACY #117
  • Facility Address: 24350 KUYKENDAHL ROAD ATTN PHARMACIST IN CHARGE
    TOMBALL, TX
    ZIP 77375
  • Facility Phone: 513 762-1263
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEBBIE VESELKA
  • NPI Number: 1861813354
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2075527
LAB Type Pharmacy
Facility Name KROGER PHARMACY #117
Street 24350 KUYKENDAHL ROAD ATTN PHARMACIST IN CHARGE
City TOMBALL
State TX
ZIP 77375
Phone 513 762-1263
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2024
Certificate Expiration Date 3/30/2026
Facility Type Pharmacy
Lab Director DEBBIE VESELKA

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