42D1001173 CLIA NUMBER - KROGER PHARMACY

Laboratory Demographics

  • CLIA Code: 42D1001173
  • Facility Name: KROGER PHARMACY
  • Facility Address: 3403 FOREST DRIVE
    COLUMBIA, SC
    ZIP 29204
  • Facility Phone: 803 782-4027
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: LIZA CHAPMAN
  • NPI Number: 1699709329
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D1001173
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY
Street 3403 FOREST DRIVE
City COLUMBIA
State SC
ZIP 29204
Phone 803 782-4027
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2024
Certificate Expiration Date 4/12/2026
Facility Type Other - RETAIL PHARMACY
Lab Director LIZA CHAPMAN

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