45D2119321 CLIA NUMBER - KROGER P HARMACY #530

Laboratory Demographics

  • CLIA Code: 45D2119321
  • Facility Name: KROGER P HARMACY #530
  • Facility Address: 1653 BASSWOOD BLVD
    FORT WORTH, TX
    ZIP 76131
  • Facility Phone: 214 597-4332
  • Facility Type: Other - PHARMACY
  • Facility Type: Waiver
  • Lab Director: MARIBETH FINN
  • NPI Number: 1164977278
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2119321
LAB Type Other - PHARMACY
Facility Name KROGER P HARMACY #530
Street 1653 BASSWOOD BLVD
City FORT WORTH
State TX
ZIP 76131
Phone 214 597-4332
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Other - PHARMACY
Lab Director MARIBETH FINN

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