42D2167880 CLIA NUMBER - KROGER PHARMACY 011-703

Laboratory Demographics

  • CLIA Code: 42D2167880
  • Facility Name: KROGER PHARMACY 011-703
  • Facility Address: 27 DISCOVERY DR
    BLUFFTON, SC
    ZIP 29910
  • Facility Phone: 843 989-7030
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1861426595
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2167880
LAB Type Pharmacy
Facility Name KROGER PHARMACY 011-703
Street 27 DISCOVERY DR
City BLUFFTON
State SC
ZIP 29910
Phone 843 989-7030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2025
Certificate Expiration Date 6/17/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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