11D0257984 CLIA NUMBER - SOUTHERN CRESCENT NEPHROLOGY PC

Laboratory Demographics

  • CLIA Code: 11D0257984
  • Facility Name: SOUTHERN CRESCENT NEPHROLOGY PC
  • Facility Address: 34 UPPER RIVERDALE RD SE, SUITE 202
    RIVERDALE, GA
    ZIP 30274
  • Facility Phone: 770 991-2510
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: UMA M. KUMAR
  • NPI Number: 1366841744
  • Taxonomy: 2084N0400X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 11D0257984
LAB Type Physician Office
Facility Name SOUTHERN CRESCENT NEPHROLOGY PC
Street 34 UPPER RIVERDALE RD SE, SUITE 202
City RIVERDALE
State GA
ZIP 30274
Phone 770 991-2510
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/17/2024
Certificate Expiration Date 2/16/2026
Facility Type Physician Office
Lab Director UMA M. KUMAR

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