11D2064147 CLIA NUMBER - KROGER PHARMACY #364

Laboratory Demographics

  • CLIA Code: 11D2064147
  • Facility Name: KROGER PHARMACY #364
  • Facility Address: 2685 METROPOLITAN PKWY, ATTN PHARMACIST IN CHARGE
    ATLANTA, GA
    ZIP 30315
  • Facility Phone: 404 209-6638
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: LIZA CHAPMAN
  • NPI Number: 1518991348
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2064147
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY #364
Street 2685 METROPOLITAN PKWY, ATTN PHARMACIST IN CHARGE
City ATLANTA
State GA
ZIP 30315
Phone 404 209-6638
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2025
Certificate Expiration Date 8/14/2027
Facility Type Other - RETAIL PHARMACY
Lab Director LIZA CHAPMAN

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