11D2009487 CLIA NUMBER - KROGER PHARMACY #676

Laboratory Demographics

  • CLIA Code: 11D2009487
  • Facility Name: KROGER PHARMACY #676
  • Facility Address: 2801 WASHINGTON ROAD
    AUGUSTA, GA
    ZIP 30909
  • Facility Phone: 706 731-7333
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1033143862
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2009487
LAB Type Pharmacy
Facility Name KROGER PHARMACY #676
Street 2801 WASHINGTON ROAD
City AUGUSTA
State GA
ZIP 30909
Phone 706 731-7333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2024
Certificate Expiration Date 7/5/2026
Facility Type Pharmacy
Lab Director CHUCK PAGE

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