11D2118911 CLIA NUMBER - KROGER PHARMACY #416

Laboratory Demographics

  • CLIA Code: 11D2118911
  • Facility Name: KROGER PHARMACY #416
  • Facility Address: 7380 SPOUT SPRINGS ROAD
    FLOWERY BRANCH, GA
    ZIP 30542
  • Facility Phone: 770 965-5644
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LIZA CHAPMAN
  • NPI Number: 1245264050
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2118911
LAB Type Pharmacy
Facility Name KROGER PHARMACY #416
Street 7380 SPOUT SPRINGS ROAD
City FLOWERY BRANCH
State GA
ZIP 30542
Phone 770 965-5644
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Pharmacy
Lab Director LIZA CHAPMAN

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