45D2100184 CLIA NUMBER - KROGER PHARMACY #591

Laboratory Demographics

  • CLIA Code: 45D2100184
  • Facility Name: KROGER PHARMACY #591
  • Facility Address: 1631 SW WILSHIRE BLVD, ATTN PHARMACIST IN CHARGE
    BURLESON, TX
    ZIP 76028
  • Facility Phone: 713 507-6276
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: JEFF LOESCH
  • NPI Number: 1801279815
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2100184
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY #591
Street 1631 SW WILSHIRE BLVD, ATTN PHARMACIST IN CHARGE
City BURLESON
State TX
ZIP 76028
Phone 713 507-6276
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Other - RETAIL PHARMACY
Lab Director JEFF LOESCH

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