11D0878744 CLIA NUMBER - DIALYSIS AMERICA GEORGIA, LLC FRESENIUS KIDNEY CARE PERIMETER

Laboratory Demographics

CLIA Number: 11D0878744

Facility Name: DIALYSIS AMERICA GEORGIA, LLC FRESENIUS KIDNEY CARE PERIMETER

Facility Address:
5825 GLENRIDGE DRIVE,SUITE 3-150
ATLANTA, GA
ZIP 30328
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Facility Phone Number: 404 250-0058

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1962514778

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D0878744
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DIALYSIS AMERICA GEORGIA, LLC FRESENIUS KIDNEY CARE PERIMETER
Street	5825 GLENRIDGE DRIVE,SUITE 3-150
City	ATLANTA
State	GA
ZIP	30328
Phone	404 250-0058
CertificateType	4
CertificateEffectiveDate	11/2/2023
CertificateExpirationDate	11/1/2025
FacilityType	Waiver

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