45D2108798 CLIA NUMBER - KROGER PHARMACY #573

Laboratory Demographics

  • CLIA Code: 45D2108798
  • Facility Name: KROGER PHARMACY #573
  • Facility Address: 1250 N PRESTON RD
    PROSPER, TX
    ZIP 75078
  • Facility Phone: 713 507-6276
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: REGINA JANES
  • NPI Number: 1336506278
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2108798
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY #573
Street 1250 N PRESTON RD
City PROSPER
State TX
ZIP 75078
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 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type Other - RETAIL PHARMACY
Lab Director REGINA JANES

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