11D2098466 CLIA NUMBER - KROGER PHARMACY #487

Laboratory Demographics

  • CLIA Code: 11D2098466
  • Facility Name: KROGER PHARMACY #487
  • Facility Address: 555 WEST OGLETHORPE ROAD
    HINESVILLE, GA
    ZIP 31313
  • Facility Phone: 912 876-6675
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1366476103
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2098466
LAB Type Pharmacy
Facility Name KROGER PHARMACY #487
Street 555 WEST OGLETHORPE ROAD
City HINESVILLE
State GA
ZIP 31313
Phone 912 876-6675
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2025
Certificate Expiration Date 7/7/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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