11D1096813 CLIA NUMBER - KROGER PHARMACY NUMBER 688

Laboratory Demographics

  • CLIA Code: 11D1096813
  • Facility Name: KROGER PHARMACY NUMBER 688
  • Facility Address: 53 EXCHANGE STREET
    RICHMOND HILL, GA
    ZIP 31324
  • Facility Phone: 912 459-3030
  • Facility Type: Industrial
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1134398621
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D1096813
LAB Type Industrial
Facility Name KROGER PHARMACY NUMBER 688
Street 53 EXCHANGE STREET
City RICHMOND HILL
State GA
ZIP 31324
Phone 912 459-3030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Industrial
Lab Director CHUCK PAGE

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