11D0951076 CLIA NUMBER - DECATUR DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D0951076
  • Facility Name: DECATUR DIALYSIS
  • Facility Address: 1987 CANDLER ROAD
    DECATUR, GA
    ZIP 30032
  • Facility Phone: 404 286-1700
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: EVELYN LEWIS
  • NPI Number: 1295704138
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0951076
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DECATUR DIALYSIS
Street 1987 CANDLER ROAD
City DECATUR
State GA
ZIP 30032
Phone 404 286-1700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director EVELYN LEWIS

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This page was last updated on: 3/20/2025