42D2009090 CLIA NUMBER - KROGER PHARMACY #002

Laboratory Demographics

  • CLIA Code: 42D2009090
  • Facility Name: KROGER PHARMACY #002
  • Facility Address: 7467 ST ANDREWS RD, STE 6
    IRMO, SC
    ZIP 29063
  • Facility Phone: 803 732-0426
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LIZA G. CHAPMAN
  • NPI Number: 1447284161
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2009090
LAB Type Pharmacy
Facility Name KROGER PHARMACY #002
Street 7467 ST ANDREWS RD, STE 6
City IRMO
State SC
ZIP 29063
Phone 803 732-0426
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: 9/29/2025