11D0984294 CLIA NUMBER - KROGER PHARMACY# 425

Laboratory Demographics

  • CLIA Code: 11D0984294
  • Facility Name: KROGER PHARMACY# 425
  • Facility Address: 5928 ZEBULON ROAD
    MACON, GA
    ZIP 31210
  • Facility Phone: 478 757-4152
  • Facility Type: Other - PHARMACY
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1073538757
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D0984294
LAB Type Other - PHARMACY
Facility Name KROGER PHARMACY# 425
Street 5928 ZEBULON ROAD
City MACON
State GA
ZIP 31210
Phone 478 757-4152
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 Other - PHARMACY
Lab Director CHUCK PAGE

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