42D2116165 CLIA NUMBER - KROGER PHARMACY #678

Laboratory Demographics

  • CLIA Code: 42D2116165
  • Facility Name: KROGER PHARMACY #678
  • Facility Address: 1028 ROBERTS BRANCH PARKWAY
    COLUMBIA, SC
    ZIP 29203
  • Facility Phone: 803 234-7150
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: LIZA CHAPMAN
  • NPI Number: 1003262809
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2116165
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY #678
Street 1028 ROBERTS BRANCH PARKWAY
City COLUMBIA
State SC
ZIP 29203
Phone 803 234-7150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Other - RETAIL PHARMACY
Lab Director LIZA CHAPMAN

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