11D0954310 CLIA NUMBER - SOUTH FULTON DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 11D0954310

Facility Name: SOUTH FULTON DIALYSIS CENTER

Facility Address:
3268 GREENBRIAR PARKWAY
ATLANTA, GA
ZIP 30331
Get Directions

Facility Phone Number: 404 997-6700

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1417016551

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D0954310
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	SOUTH FULTON DIALYSIS CENTER
Street	3268 GREENBRIAR PARKWAY
City	ATLANTA
State	GA
ZIP	30331
Phone	404 997-6700
CertificateType	4
CertificateEffectiveDate	7/18/2022
CertificateExpirationDate	7/17/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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