11D0984300 CLIA NUMBER - KROGER PHARMACY #407

Laboratory Demographics

  • CLIA Code: 11D0984300
  • Facility Name: KROGER PHARMACY #407
  • Facility Address: 1367 SAM NUNN BLVD
    PERRY, GA
    ZIP 31069
  • Facility Phone: 478 988-8398
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LIZA CHAPMAN
  • NPI Number: 1174557904
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0984300
LAB Type Pharmacy
Facility Name KROGER PHARMACY #407
Street 1367 SAM NUNN BLVD
City PERRY
State GA
ZIP 31069
Phone 478 988-8398
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 LIZA CHAPMAN

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: 3/20/2025