11D2099860 CLIA NUMBER - KROGER PHARMACY #356

Laboratory Demographics

  • CLIA Code: 11D2099860
  • Facility Name: KROGER PHARMACY #356
  • Facility Address: 3600 DALLAS HWY
    MARIETTA, GA
    ZIP 30064
  • Facility Phone: 770 425-0552
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1932124617
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2099860
LAB Type Pharmacy
Facility Name KROGER PHARMACY #356
Street 3600 DALLAS HWY
City MARIETTA
State GA
ZIP 30064
Phone 770 425-0552
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Pharmacy
Lab Director CHUCK PAGE

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