11D2313445 CLIA NUMBER - KROGER PHARMACY #011-639

Laboratory Demographics

  • CLIA Code: 11D2313445
  • Facility Name: KROGER PHARMACY #011-639
  • Facility Address: 1006 MARTINS CHAPEL ROAD
    LAWRENCEVILLE, GA
    ZIP 30045
  • Facility Phone: 770 496-5332
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHUCK PAGE
  • NPI Number: 1710335443
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2313445
LAB Type Pharmacy
Facility Name KROGER PHARMACY #011-639
Street 1006 MARTINS CHAPEL ROAD
City LAWRENCEVILLE
State GA
ZIP 30045
Phone 770 496-5332
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
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: 9/29/2025