CLIA lab
CLIA 45D1095004: Kroger Pharmacy 490
Henderson, TX. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 45D1095004 belongs to Kroger Pharmacy 490 in Henderson, TX.
Certificate of Waiver, effective January 30, 2025, expires January 29, 2027.
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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- January 30, 2025
- Certificate expiration
- January 29, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 30, 2009
- 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
- 45D1095004
- Lab name
- Kroger Pharmacy 490
- Address
- 2415 Hwy 79 South, Henderson, TX 75652
- Phone
- (903) 657-8596
- Fax
- (903) 657-1520
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 Henderson, TX
- Across the Board Home HealthcareCertificate of Waiver, Home health agency45D2119484
- Angel Care Hospice LLCCertificate of Waiver, Hospice45D1081596
- Autumn Leaves Nursing & Rehabilitation Center IncCertificate of Waiver, Skilled nursing or nursing facility45D0997203
- Brookdale HendersonCertificate of Waiver, Assisted living facility45D2193177
- Christus Emergency Center HendersonCertificate of Accreditation, Other45D2326257
- Christus Trinity Clinic HendersonCertificate of Waiver, Rural health clinic45D0687794
- Disability Services of the Southwest, IncCertificate of Waiver, Home health agency45D1081459
- Family Care of Henderson, PLLCCertificate of Waiver, Other practitioner45D2277993
- Happy at Home HealthcareCertificate of Waiver, Home health agency45D0877901
- Henderson Dialysis CenterCertificate of Waiver, End stage renal disease dialysis facility45D0960626
Related
Questions
What is the CLIA number for Kroger Pharmacy 490 in Henderson?
45D1095004, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kroger Pharmacy 490 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 45D1095004 expire?
The CMS file lists January 29, 2027 as the certificate expiration date; the certificate took effect January 30, 2025.