11D2123760 CLIA NUMBER - KROGER PHARMACY #697

Laboratory Demographics

  • CLIA Code: 11D2123760
  • Facility Name: KROGER PHARMACY #697
  • Facility Address: 318 MALL BLVD, SUITE 100
    SAVANNAH, GA
    ZIP 31406
  • Facility Phone: 912 200-9165
  • Facility Type: Other - PHARMACY
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1578985776
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2123760
LAB Type Other - PHARMACY
Facility Name KROGER PHARMACY #697
Street 318 MALL BLVD, SUITE 100
City SAVANNAH
State GA
ZIP 31406
Phone 912 200-9165
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Other - PHARMACY
Lab Director CHUCK PAGE

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