11D0897879 CLIA NUMBER - EAST MACON DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 11D0897879
  • Facility Name: EAST MACON DIALYSIS CENTER
  • Facility Address: 165 EMERY HIGHWAY SUITE 101
    MACON, GA
    ZIP 31217
  • Facility Phone: 912 755-1144
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: CARLOS MARTINEZ
  • NPI Number: 1073582425
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0897879
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name EAST MACON DIALYSIS CENTER
Street 165 EMERY HIGHWAY SUITE 101
City MACON
State GA
ZIP 31217
Phone 912 755-1144
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director CARLOS MARTINEZ

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