11D1004711 CLIA NUMBER - SOUTHERN CRESCENT NEPHROLOGY PC

Laboratory Demographics

  • CLIA Code: 11D1004711
  • Facility Name: SOUTHERN CRESCENT NEPHROLOGY PC
  • Facility Address: 250 VILLAGE CENTER PARKWAY
    STOCKBRIDGE, GA
    ZIP 30281
  • Facility Phone: 678 289-0508
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: UMA M. KUMAR MD
  • NPI Number: 1659328474
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1004711
LAB Type Physician Office
Facility Name SOUTHERN CRESCENT NEPHROLOGY PC
Street 250 VILLAGE CENTER PARKWAY
City STOCKBRIDGE
State GA
ZIP 30281
Phone 678 289-0508
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Physician Office
Lab Director UMA M. KUMAR MD

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