11D2097106 CLIA NUMBER - KROGER PHARMACY #434

Laboratory Demographics

  • CLIA Code: 11D2097106
  • Facility Name: KROGER PHARMACY #434
  • Facility Address: 3651 PEACHTREE PKWY
    SUWANEE, GA
    ZIP 30024
  • Facility Phone: 770 418-2388
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1790700474
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2097106
LAB Type Pharmacy
Facility Name KROGER PHARMACY #434
Street 3651 PEACHTREE PKWY
City SUWANEE
State GA
ZIP 30024
Phone 770 418-2388
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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