11D2098148 CLIA NUMBER - KROGER PHARMACY #443

Laboratory Demographics

  • CLIA Code: 11D2098148
  • Facility Name: KROGER PHARMACY #443
  • Facility Address: 910 ATHENS HIGHWAY
    LOGANVILLE, GA
    ZIP 30052
  • Facility Phone: 770 554-1111
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1386678126
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2098148
LAB Type Pharmacy
Facility Name KROGER PHARMACY #443
Street 910 ATHENS HIGHWAY
City LOGANVILLE
State GA
ZIP 30052
Phone 770 554-1111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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