11D1048914 CLIA NUMBER - SUGARLOAF DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D1048914
  • Facility Name: SUGARLOAF DIALYSIS
  • Facility Address: 1705 BELLE MEDE COURT SUITE 110
    LAWRENCEVILLE, GA
    ZIP 30043
  • Facility Phone: 770 513-2833
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: WILLIAM G. PAXTON
  • NPI Number: 1669426813
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1048914
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SUGARLOAF DIALYSIS
Street 1705 BELLE MEDE COURT SUITE 110
City LAWRENCEVILLE
State GA
ZIP 30043
Phone 770 513-2833
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director WILLIAM G. PAXTON

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