11D0668586 CLIA NUMBER - QUITMAN DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D0668586
  • Facility Name: QUITMAN DIALYSIS
  • Facility Address: 101 EAST DAVIS ST
    QUITMAN, GA
    ZIP 31643
  • Facility Phone: 229 263-6340
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RAUL G. SANTOS
  • NPI Number: 1538670047
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0668586
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name QUITMAN DIALYSIS
Street 101 EAST DAVIS ST
City QUITMAN
State GA
ZIP 31643
Phone 229 263-6340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RAUL G. SANTOS

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