11D2098149 CLIA NUMBER - KROGER PHARMACY #445

Laboratory Demographics

  • CLIA Code: 11D2098149
  • Facility Name: KROGER PHARMACY #445
  • Facility Address: 6678 COVINGTON HIGHWAY
    LITHONIA, GA
    ZIP 30058
  • Facility Phone: 770 593-7111
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1093749830
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2098149
LAB Type Pharmacy
Facility Name KROGER PHARMACY #445
Street 6678 COVINGTON HIGHWAY
City LITHONIA
State GA
ZIP 30058
Phone 770 593-7111
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