11D2097313 CLIA NUMBER - KROGER PHARMACY #441

Laboratory Demographics

  • CLIA Code: 11D2097313
  • Facility Name: KROGER PHARMACY #441
  • Facility Address: 2300 HOLCOMB BRIDGE RD
    ROSWELL, GA
    ZIP 30075
  • Facility Phone: 678 352-7480
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1912931726
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2097313
LAB Type Pharmacy
Facility Name KROGER PHARMACY #441
Street 2300 HOLCOMB BRIDGE RD
City ROSWELL
State GA
ZIP 30075
Phone 678 352-7480
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: 9/29/2025