11D0954653 CLIA NUMBER - CARROLL COUNTY NEPHROLOGY PC

Laboratory Demographics

  • CLIA Code: 11D0954653
  • Facility Name: CARROLL COUNTY NEPHROLOGY PC
  • Facility Address: 157 CLINIC AVENUE SUITE 203
    CARROLLTON, GA
    ZIP 30117
  • Facility Phone: 770 832-0429
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRYAN QUINN
  • NPI Number: 1285814988
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0954653
LAB Type Physician Office
Facility Name CARROLL COUNTY NEPHROLOGY PC
Street 157 CLINIC AVENUE SUITE 203
City CARROLLTON
State GA
ZIP 30117
Phone 770 832-0429
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Physician Office
Lab Director BRYAN QUINN

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