11D0984274 CLIA NUMBER - KROGER PHARMACY #400

Laboratory Demographics

  • CLIA Code: 11D0984274
  • Facility Name: KROGER PHARMACY #400
  • Facility Address: 4321 HARTLEY BRIDGE ROAD
    MACON, GA
    ZIP 31216
  • Facility Phone: 478 788-1015
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1568496305
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0984274
LAB Type Pharmacy
Facility Name KROGER PHARMACY #400
Street 4321 HARTLEY BRIDGE ROAD
City MACON
State GA
ZIP 31216
Phone 478 788-1015
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2024
Certificate Expiration Date 9/14/2026
Facility Type Pharmacy
Lab Director CHUCK PAGE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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