11D2099806 CLIA NUMBER - KROGER PHARMACY #320

Laboratory Demographics

  • CLIA Code: 11D2099806
  • Facility Name: KROGER PHARMACY #320
  • Facility Address: 1745 HIGHWAY #138
    CONYERS, GA
    ZIP 30013
  • Facility Phone: 770 922-0447
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1598799322
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2099806
LAB Type Pharmacy
Facility Name KROGER PHARMACY #320
Street 1745 HIGHWAY #138
City CONYERS
State GA
ZIP 30013
Phone 770 922-0447
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2023
Certificate Expiration Date 8/2/2025
Facility Type 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: 3/20/2025