11D2098208 CLIA NUMBER - KROGER PHARMACY #451

Laboratory Demographics

  • CLIA Code: 11D2098208
  • Facility Name: KROGER PHARMACY #451
  • Facility Address: 4715 ATLANTA ROAD SE
    SMYRNA, GA
    ZIP 30339
  • Facility Phone: 404 792-6980
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1164456976
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2098208
LAB Type Pharmacy
Facility Name KROGER PHARMACY #451
Street 4715 ATLANTA ROAD SE
City SMYRNA
State GA
ZIP 30339
Phone 404 792-6980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2025
Certificate Expiration Date 7/1/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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