CLIA lab
CLIA 11D2140576: Kroger Pharmacy #457
Dacula, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2140576 belongs to Kroger Pharmacy #457 in Dacula, GA.
Certificate of Waiver, effective November 27, 2025, expires November 26, 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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- November 27, 2025
- Certificate expiration
- November 26, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 27, 2017
- Facility type
- Other
- 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
- 11D2140576
- Lab name
- Kroger Pharmacy #457
- Address
- 2700 Braselton Highway, Dacula, GA 30019
- Phone
- (770) 614-1022
- Fax
- (770) 614-4413
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 Dacula, GA
- A Heart of A NurseCertificate of Waiver, Mobile lab11D2299495
- Advanced Dermatology of GeorgiaCertificate for Provider-Performed Microscopy Procedures, Physician office11D2050149
- Alana Recovery Centers, LLC DBA Promises AtlCertificate of Waiver, Other11D2313468
- Align Mobile Medical Services LLCCertificate of Waiver, Other11D2268547
- Arbor Terrace at Hamilton MillCertificate of Waiver, Assisted living facility11D2107688
- Ball PediatricsCertificate of Waiver, Physician office11D0995408
- Bio-Medical Applications of Georgia, IncCertificate of Waiver, End stage renal disease dialysis facility11D2118758
- Burgeon MedixCertificate of Waiver, Mobile lab11D2339742
- Children's at Hamilton Creek Urgent Care LabCertificate of Accreditation, Other11D2128348
- Cornerstone PediatricsCertificate of Waiver, Physician office11D2141641
Related
Questions
What is the CLIA number for Kroger Pharmacy #457 in Dacula?
11D2140576, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kroger Pharmacy #457 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2140576 expire?
The CMS file lists November 26, 2027 as the certificate expiration date; the certificate took effect November 27, 2025.