11D0965483 CLIA NUMBER - FMC DIALYSIS SERVICES MUSCOGEE COUNTY

Laboratory Demographics

CLIA Number: 11D0965483

Facility Name: FMC DIALYSIS SERVICES MUSCOGEE COUNTY

Facility Address:
1851 MANCHESTER EXPWY
COLUMBUS, GA
ZIP 31904
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Facility Phone Number: 334 749-5085

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1407968217

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D0965483
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FMC DIALYSIS SERVICES MUSCOGEE COUNTY
Street	1851 MANCHESTER EXPWY
City	COLUMBUS
State	GA
ZIP	31904
Phone	334 749-5085
CertificateType	4
CertificateEffectiveDate	9/22/2023
CertificateExpirationDate	9/21/2025
FacilityType	Waiver

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