11D0984210 CLIA NUMBER - KROGER PHARMACY #393

Laboratory Demographics

  • CLIA Code: 11D0984210
  • Facility Name: KROGER PHARMACY #393
  • Facility Address: 136 WEST BELMONT DRIVE SW
    CALHOUN, GA
    ZIP 30701
  • Facility Phone: 706 625-4211
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1467486209
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D0984210
LAB Type Pharmacy
Facility Name KROGER PHARMACY #393
Street 136 WEST BELMONT DRIVE SW
City CALHOUN
State GA
ZIP 30701
Phone 706 625-4211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Pharmacy
Lab Director CHUCK PAGE

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