11D0983603 CLIA NUMBER - FOREST PARK DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 11D0983603
  • Facility Name: FOREST PARK DIALYSIS CENTER
  • Facility Address: 380 FOREST PARKWAY
    FOREST PARK, GA
    ZIP 30297
  • Facility Phone: 253 272-1916
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JANICE WEATHERSPOON
  • NPI Number: 1770622201
  • Taxonomy: 1223G0001X - Dentist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0983603
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FOREST PARK DIALYSIS CENTER
Street 380 FOREST PARKWAY
City FOREST PARK
State GA
ZIP 30297
Phone 253 272-1916
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JANICE WEATHERSPOON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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