11D0983398 CLIA NUMBER - KROGER PHARMACY #335

Laboratory Demographics

  • CLIA Code: 11D0983398
  • Facility Name: KROGER PHARMACY #335
  • Facility Address: 4880 LOWER ROSWELL ROAD
    MARIETTA, GA
    ZIP 30068
  • Facility Phone: 770 496-7456
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1942234778
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D0983398
LAB Type Pharmacy
Facility Name KROGER PHARMACY #335
Street 4880 LOWER ROSWELL ROAD
City MARIETTA
State GA
ZIP 30068
Phone 770 496-7456
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