42D2111707 CLIA NUMBER - KROGER PHARMACY #675

Laboratory Demographics

  • CLIA Code: 42D2111707
  • Facility Name: KROGER PHARMACY #675
  • Facility Address: 1795 WHISKEY ROAD
    AIKEN, SC
    ZIP 29803
  • Facility Phone: 803 642-5371
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: LIZA CHAPMAN
  • NPI Number: 1770517401
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2111707
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY #675
Street 1795 WHISKEY ROAD
City AIKEN
State SC
ZIP 29803
Phone 803 642-5371
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