CLIA lab
CLIA 45D1057175: Kroger Pharmacy 512
Southlake, TX. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 45D1057175 belongs to Kroger Pharmacy 512 in Southlake, TX.
Certificate of Waiver, effective August 4, 2026, expires August 3, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- August 4, 2026
- Certificate expiration
- August 3, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 4, 2006
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 45D1057175
- Lab name
- Kroger Pharmacy 512
- Address
- 2110 E Southlake Blvd, Southlake, TX 76092
- Phone
- (817) 421-7487
- Fax
- (817) 251-8715
Annual test volume the lab reported
- Waived tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Southlake, TX
- Acute Care and Family MedicineCertificate for Provider-Performed Microscopy Procedures, Physician office45D1007246
- Advanced Allergy & Asthma AssociatesCertificate of Waiver, Physician office45D2179463
- Alpha Men's HealthCertificate of Compliance, Other practitioner45D2295244
- Arbor PediatricsCertificate of Waiver, Physician office45D2206557
- Arise Recovery Centers SouthlakeCertificate of Waiver, Other45D2153375
- Atlantis Men's Health, PLLC DBA Elixir 360 HealthCertificate of Waiver, Physician office45D2330423
- Axis Surgery Center, LLCCertificate of Waiver, Ambulatory surgery center45D2211344
- BSW Southlake PediatricsCertificate of Waiver, Physician office45D2328211
- BSW Southlake Urgent CareCertificate of Waiver, Other45D2251077
- Baylor Scott & White Southlake Family MedicineCertificate of Waiver, Physician office45D0916018
Related
Questions
What is the CLIA number for Kroger Pharmacy 512 in Southlake?
45D1057175, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kroger Pharmacy 512 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 45D1057175 expire?
The CMS file lists August 3, 2028 as the certificate expiration date; the certificate took effect August 4, 2026.