11D0675481 CLIA NUMBER - COLUMBUS DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 11D0675481

Facility Name: COLUMBUS DIALYSIS CENTER

Facility Address:
6228 BRADLEY PARK DRIVE SUITE B
COLUMBUS, GA
ZIP 31904
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Facility Phone Number: 706 596-8222

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1467421388

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D0675481
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	COLUMBUS DIALYSIS CENTER
Street	6228 BRADLEY PARK DRIVE SUITE B
City	COLUMBUS
State	GA
ZIP	31904
Phone	706 596-8222
CertificateType	4
CertificateEffectiveDate	1/1/2024
CertificateExpirationDate	12/31/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024