42D1005278 CLIA NUMBER - KROGER PHARMACY # 25

Laboratory Demographics

  • CLIA Code: 42D1005278
  • Facility Name: KROGER PHARMACY # 25
  • Facility Address: 2939 HIGHWAY 17 SOUTH
    GARDEN CITY, SC
    ZIP 29576
  • Facility Phone: 843 357-4300
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LIZA G. CHAPMAN
  • NPI Number: 1235163965
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D1005278
LAB Type Pharmacy
Facility Name KROGER PHARMACY # 25
Street 2939 HIGHWAY 17 SOUTH
City GARDEN CITY
State SC
ZIP 29576
Phone 843 357-4300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2024
Certificate Expiration Date 6/24/2026
Facility Type Pharmacy
Lab Director LIZA G. CHAPMAN

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This page was last updated on: 3/20/2025