11D0900108 CLIA NUMBER - BRUNSWICK SOUTH DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D0900108
  • Facility Name: BRUNSWICK SOUTH DIALYSIS
  • Facility Address: 2930 SPRINGDALE ROAD
    BRUNSWICK, GA
    ZIP 31520
  • Facility Phone: 912 264-1507
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: BRYAN J. KRULL
  • NPI Number: 1922054410
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0900108
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BRUNSWICK SOUTH DIALYSIS
Street 2930 SPRINGDALE ROAD
City BRUNSWICK
State GA
ZIP 31520
Phone 912 264-1507
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director BRYAN J. KRULL

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