11D0983351 CLIA NUMBER - KROGER PHARMACY #390

Laboratory Demographics

  • CLIA Code: 11D0983351
  • Facility Name: KROGER PHARMACY #390
  • Facility Address: 10945 STATES BRIDGE ROAD
    ALPHARETTA, GA
    ZIP 30022
  • Facility Phone: 770 751-3010
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1528083201
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D0983351
LAB Type Pharmacy
Facility Name KROGER PHARMACY #390
Street 10945 STATES BRIDGE ROAD
City ALPHARETTA
State GA
ZIP 30022
Phone 770 751-3010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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