11D0996859 CLIA NUMBER - NORTH GEORGIA NEPHROLOGY CONSULTANTS LLC

Laboratory Demographics

CLIA Number: 11D0996859

Facility Name: NORTH GEORGIA NEPHROLOGY CONSULTANTS LLC

Facility Address:
5105 JEFFERSON ROAD SUITE B
ATHENS, GA
ZIP 30607
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Facility Phone Number: 706 227-4075

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1275668394

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	11D0996859
LAB Type	Physician Office
Facility Name	NORTH GEORGIA NEPHROLOGY CONSULTANTS LLC
Street	5105 JEFFERSON ROAD SUITE B
City	ATHENS
State	GA
ZIP	30607
Phone	706 227-4075
CertificateType	4
CertificateEffectiveDate	2/29/2024
CertificateExpirationDate	2/27/2026
FacilityType	Waiver

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