11D0984273 CLIA NUMBER - KROGER PHARMACY 665

Laboratory Demographics

  • CLIA Code: 11D0984273
  • Facility Name: KROGER PHARMACY 665
  • Facility Address: 2040 BARNETT SHOALS ROAD
    ATHENS, GA
    ZIP 30605
  • Facility Phone: 706 353-6882
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1043244866
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D0984273
LAB Type Pharmacy
Facility Name KROGER PHARMACY 665
Street 2040 BARNETT SHOALS ROAD
City ATHENS
State GA
ZIP 30605
Phone 706 353-6882
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/20/2025
Certificate Expiration Date 3/19/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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