11D2097311 CLIA NUMBER - KROGER PHARMACY #440

Laboratory Demographics

  • CLIA Code: 11D2097311
  • Facility Name: KROGER PHARMACY #440
  • Facility Address: 950 HERRINGTON RD
    LAWRENCEVILLE, GA
    ZIP 30044
  • Facility Phone: (770) 995-6210
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1558395392
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2097311
LAB Type Pharmacy
Facility Name KROGER PHARMACY #440
Street 950 HERRINGTON RD
City LAWRENCEVILLE
State GA
ZIP 30044
Phone 7709956210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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This page was last updated on: 5/18/2026