11D2098461 CLIA NUMBER - KROGER PHARMACY #483

Laboratory Demographics

  • CLIA Code: 11D2098461
  • Facility Name: KROGER PHARMACY #483
  • Facility Address: 1670 HIGHWAY 124 SUITE F
    SNELLVILLE, GA
    ZIP 30078
  • Facility Phone: 770 985-3792
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1811921703
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2098461
LAB Type Pharmacy
Facility Name KROGER PHARMACY #483
Street 1670 HIGHWAY 124 SUITE F
City SNELLVILLE
State GA
ZIP 30078
Phone 770 985-3792
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2023
Certificate Expiration Date 7/7/2025
Facility Type Pharmacy
Lab Director CHUCK PAGE

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This page was last updated on: 6/4/2025