11D2000474 CLIA NUMBER - KROGER PHARMACY # 324

Laboratory Demographics

  • CLIA Code: 11D2000474
  • Facility Name: KROGER PHARMACY # 324
  • Facility Address: 2090 DUNWOODY CLUB DRIVE
    ATLANTA, GA
    ZIP 30350
  • Facility Phone: 770 391-9792
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1508890328
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2000474
LAB Type Pharmacy
Facility Name KROGER PHARMACY # 324
Street 2090 DUNWOODY CLUB DRIVE
City ATLANTA
State GA
ZIP 30350
Phone 770 391-9792
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Pharmacy
Lab Director CHUCK PAGE

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