CLIA lab
CLIA 11D2099004: Kroger Pharmacy #673
Dallas, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2099004 belongs to Kroger Pharmacy #673 in Dallas, GA.
Certificate of Waiver, effective July 20, 2025, expires July 19, 2027.
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
- July 20, 2025
- Certificate expiration
- July 19, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 20, 2015
- 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
- 11D2099004
- Lab name
- Kroger Pharmacy #673
- Address
- 457 Nathan Dean Blvd, Dallas, GA 30132
- Phone
- (770) 443-8776
- Fax
- (770) 443-6917
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.
Other labs in Dallas, GA
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- Advanced Urology Institute of Georgia, PCCertificate of Waiver, Physician office11D2338686
- Allcare DallasCertificate of Waiver, Physician office11D2227370
- Amazing Grace Hospice Care, LLCCertificate of Waiver, Hospice11D2286245
- Anna Chos LLC DBA Anna Chos Urgent ClinicCertificate for Provider-Performed Microscopy Procedures, Physician office11D2343709
- Aqua Dermatology of Georgia - HiramCertificate of Compliance, Physician office11D2235821
- Blue Ridge Care Center, LLCCertificate of Waiver, Skilled nursing or nursing facility11D2326792
- C&C Pharmacy, IncCertificate of Waiver, Pharmacy11D2183259
- CPM Sugery Center 2, LLCCertificate of Waiver, Ambulatory surgery center11D1099264
- Carelink of Northwest Georgia, IncCertificate of Waiver, Community clinic11D2155672
Related
Questions
What is the CLIA number for Kroger Pharmacy #673 in Dallas?
11D2099004, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kroger Pharmacy #673 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2099004 expire?
The CMS file lists July 19, 2027 as the certificate expiration date; the certificate took effect July 20, 2025.