11D2118918 CLIA NUMBER - KROGER PHARMACY #428

Laboratory Demographics

  • CLIA Code: 11D2118918
  • Facility Name: KROGER PHARMACY #428
  • Facility Address: 191 ALPS ROAD
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 706 543-3553
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1285659060
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2118918
LAB Type Pharmacy
Facility Name KROGER PHARMACY #428
Street 191 ALPS ROAD
City ATHENS
State GA
ZIP 30606
Phone 706 543-3553
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 CHUCK PAGE

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