11D2098321 CLIA NUMBER - KROGER PHARMACY #471

Laboratory Demographics

  • CLIA Code: 11D2098321
  • Facility Name: KROGER PHARMACY #471
  • Facility Address: 6055 OLD NATIONAL HIGHWAY
    COLLEGE PARK, GA
    ZIP 30349
  • Facility Phone: 770 996-5488
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1831123645
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2098321
LAB Type Pharmacy
Facility Name KROGER PHARMACY #471
Street 6055 OLD NATIONAL HIGHWAY
City COLLEGE PARK
State GA
ZIP 30349
Phone 770 996-5488
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2025
Certificate Expiration Date 7/5/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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