CLIA lab
CLIA 11D2099863: Kroger Pharmacy #367
Carrollton, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2099863 belongs to Kroger Pharmacy #367 in Carrollton, GA.
Certificate of Waiver, effective August 4, 2025, expires August 3, 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
- August 4, 2025
- Certificate expiration
- August 3, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 4, 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
- 11D2099863
- Lab name
- Kroger Pharmacy #367
- Address
- 1355 South Park St Hwy #27, Carrollton, GA 30117
- Phone
- (770) 832-9015
- Fax
- (770) 830-5524
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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- 3 16 Family Medicine- CarrolltonCertificate of Waiver, Physician office11D2229102
- 3 16 Kids Corner- CarrolltonCertificate of Waiver, Physician office11D2342098
- Air Evac EMS, Inc Air Evac #112Certificate of Waiver, Ambulance11D2065712
- Arrow PharmacyCertificate of Waiver, Pharmacy11D2236221
- Associated Pathologist, LLC DBA Pathgroup (Tanner)Certificate of Accreditation, Independent11D2272308
- Barclay House of CarrolltonCertificate of Waiver, Assisted living facility11D2195399
- Brookdale CarrolltonCertificate of Waiver, Assisted living facility11D0982207
- Carroll County Child Advocacy Center IncCertificate of Waiver, Other11D2306882
- Carroll County JailCertificate of Waiver, Other11D1001632
Related
Questions
What is the CLIA number for Kroger Pharmacy #367 in Carrollton?
11D2099863, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kroger Pharmacy #367 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2099863 expire?
The CMS file lists August 3, 2027 as the certificate expiration date; the certificate took effect August 4, 2025.