11D0997298 CLIA NUMBER - EAST GEORGIA DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 11D0997298
  • Facility Name: EAST GEORGIA DIALYSIS CENTER
  • Facility Address: 1989 STAMBUK LANE
    STATESBORO, GA
    ZIP 30458
  • Facility Phone: 912 871-6108
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: COURAGE ATEKHA
  • NPI Number: 1215128186
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0997298
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name EAST GEORGIA DIALYSIS CENTER
Street 1989 STAMBUK LANE
City STATESBORO
State GA
ZIP 30458
Phone 912 871-6108
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2024
Certificate Expiration Date 3/11/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director COURAGE ATEKHA

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