11D2099073 CLIA NUMBER - KROGER PHARMACY 011 265

Laboratory Demographics

  • CLIA Code: 11D2099073
  • Facility Name: KROGER PHARMACY 011 265
  • Facility Address: 1205 NORTH GLENWOOD ROAD
    DALTON, GA
    ZIP 30720
  • Facility Phone: (706) 226-7033
  • Facility Type: Other - PHARMACY
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1770517591
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2099073
LAB Type Other - PHARMACY
Facility Name KROGER PHARMACY 011 265
Street 1205 NORTH GLENWOOD ROAD
City DALTON
State GA
ZIP 30720
Phone 7062267033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type Other - PHARMACY
Lab Director CHUCK PAGE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 5/18/2026