11D0983372 CLIA NUMBER - KROGER PHARMACY #397

Laboratory Demographics

  • CLIA Code: 11D0983372
  • Facility Name: KROGER PHARMACY #397
  • Facility Address: 3330 COBB PARKWAY
    ACWORTH, GA
    ZIP 30101
  • Facility Phone: 770 975-8776
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1093749822
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D0983372
LAB Type Pharmacy
Facility Name KROGER PHARMACY #397
Street 3330 COBB PARKWAY
City ACWORTH
State GA
ZIP 30101
Phone 770 975-8776
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2024
Certificate Expiration Date 9/14/2026
Facility Type Pharmacy
Lab Director CHUCK PAGE

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