11D1085588 CLIA NUMBER - KROGER PHARMACY NUMBER 435

Laboratory Demographics

  • CLIA Code: 11D1085588
  • Facility Name: KROGER PHARMACY NUMBER 435
  • Facility Address: 1720 EPPS BRIDGE ROAD
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 706 583-8911
  • Facility Type: Industrial
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1730113549
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D1085588
LAB Type Industrial
Facility Name KROGER PHARMACY NUMBER 435
Street 1720 EPPS BRIDGE ROAD
City ATHENS
State GA
ZIP 30606
Phone 706 583-8911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2024
Certificate Expiration Date 6/22/2026
Facility Type Industrial
Lab Director CHUCK PAGE

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