11D2074762 CLIA NUMBER - KROGER PHARMACY #682

Laboratory Demographics

  • CLIA Code: 11D2074762
  • Facility Name: KROGER PHARMACY #682
  • Facility Address: 1931 JESSE JEWELL PARKWAY
    GAINESVILLE, GA
    ZIP 30501
  • Facility Phone: 470 252-3185
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1669893491
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2074762
LAB Type Other - RETAIL PHARMACY
Facility Name KROGER PHARMACY #682
Street 1931 JESSE JEWELL PARKWAY
City GAINESVILLE
State GA
ZIP 30501
Phone 470 252-3185
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type Other - RETAIL PHARMACY
Lab Director CHUCK PAGE

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