11D2098273 CLIA NUMBER - KROGER PHARMACY #461

Laboratory Demographics

  • CLIA Code: 11D2098273
  • Facility Name: KROGER PHARMACY #461
  • Facility Address: 1225 CAROLINE ST
    ATLANTA, GA
    ZIP 30307
  • Facility Phone: 404 880-4109
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1881628691
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2098273
LAB Type Pharmacy
Facility Name KROGER PHARMACY #461
Street 1225 CAROLINE ST
City ATLANTA
State GA
ZIP 30307
Phone 404 880-4109
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2023
Certificate Expiration Date 7/1/2025
Facility Type Pharmacy
Lab Director CHUCK PAGE

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This page was last updated on: 3/20/2025