11D1032108 CLIA NUMBER - RCG LAKE LANIER

Laboratory Demographics

  • CLIA Code: 11D1032108
  • Facility Name: RCG LAKE LANIER
  • Facility Address: 2565 THOMPSON BRIDGE ROAD
    GAINESVILLE, GA
    ZIP 30501
  • Facility Phone: 678 450-0364
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SOHAIL SALEEM
  • NPI Number: 1376655191
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1032108
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name RCG LAKE LANIER
Street 2565 THOMPSON BRIDGE ROAD
City GAINESVILLE
State GA
ZIP 30501
Phone 678 450-0364
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2025
Certificate Expiration Date 5/16/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SOHAIL SALEEM

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