11D2095897 CLIA NUMBER - KROGER PHARMACY #214

Laboratory Demographics

  • CLIA Code: 11D2095897
  • Facility Name: KROGER PHARMACY #214
  • Facility Address: 3139 US HIGHWAY #278 NE
    COVINGTON, GA
    ZIP 30014
  • Facility Phone: 770 787-4041
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1689608408
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2095897
LAB Type Pharmacy
Facility Name KROGER PHARMACY #214
Street 3139 US HIGHWAY #278 NE
City COVINGTON
State GA
ZIP 30014
Phone 770 787-4041
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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