11D0985498 CLIA NUMBER - DOUGLAS COUNTY DIALYSIS CENTER LLC

Laboratory Demographics

  • CLIA Code: 11D0985498
  • Facility Name: DOUGLAS COUNTY DIALYSIS CENTER LLC
  • Facility Address: 4645 TIMBER RIDGE ROAD SUITE 140
    DOUGLASVILLE, GA
    ZIP 30133
  • Facility Phone: 678 838-3233
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: NANCY MARSHMAN
  • NPI Number: 1649382466
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0985498
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DOUGLAS COUNTY DIALYSIS CENTER LLC
Street 4645 TIMBER RIDGE ROAD SUITE 140
City DOUGLASVILLE
State GA
ZIP 30133
Phone 678 838-3233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director NANCY MARSHMAN

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