42D1005272 CLIA NUMBER - KROGER PHARMACY #026

Laboratory Demographics

  • CLIA Code: 42D1005272
  • Facility Name: KROGER PHARMACY #026
  • Facility Address: 3735 RENEE DRIVE
    MYRTLE BEACH, SC
    ZIP 29579
  • Facility Phone: 843 236-4296
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LIZA CHAPMAN
  • NPI Number: 1053345785
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D1005272
LAB Type Pharmacy
Facility Name KROGER PHARMACY #026
Street 3735 RENEE DRIVE
City MYRTLE BEACH
State SC
ZIP 29579
Phone 843 236-4296
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Pharmacy
Lab Director LIZA CHAPMAN

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