11D2099807 CLIA NUMBER - KROGER PHARMACY #328

Laboratory Demographics

  • CLIA Code: 11D2099807
  • Facility Name: KROGER PHARMACY #328
  • Facility Address: 600 NORTH AVE
    MACON, GA
    ZIP 31211
  • Facility Phone: 478 746-5842
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1306870134
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2099807
LAB Type Pharmacy
Facility Name KROGER PHARMACY #328
Street 600 NORTH AVE
City MACON
State GA
ZIP 31211
Phone 478 746-5842
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2025
Certificate Expiration Date 8/2/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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