45D2129037 CLIA NUMBER - KROGER PHARMACY #121

Laboratory Demographics

  • CLIA Code: 45D2129037
  • Facility Name: KROGER PHARMACY #121
  • Facility Address: 9806 GASTON RD
    KATY, TX
    ZIP 77494
  • Facility Phone: 713 507-6276
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHIVA SANGENEH
  • NPI Number: 1235528605
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2129037
LAB Type Pharmacy
Facility Name KROGER PHARMACY #121
Street 9806 GASTON RD
City KATY
State TX
ZIP 77494
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 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Pharmacy
Lab Director SHIVA SANGENEH

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