CLIA lab
CLIA 11D0990509: Kroger Pharmacy #413
Jonesboro, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D0990509 belongs to Kroger Pharmacy #413 in Jonesboro, GA.
Certificate of Waiver, effective September 16, 2026, expires September 15, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 16, 2026
- Certificate expiration
- September 15, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 24, 2001
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D0990509
- Lab name
- Kroger Pharmacy #413
- Address
- 10375 Tara Blvd, Jonesboro, GA 30236
- Phone
- (770) 477-0975
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Kroger Pharmacy #413 in Jonesboro?
11D0990509, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kroger Pharmacy #413 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D0990509 expire?
The CMS file lists September 15, 2028 as the certificate expiration date; the certificate took effect September 16, 2026.