11D1061298 CLIA NUMBER - DSI MACON, LLC D/B/A US RENAL CARE GRAY DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D1061298
  • Facility Name: DSI MACON, LLC D/B/A US RENAL CARE GRAY DIALYSIS
  • Facility Address: 1002 BOULDER DRIVE
    GRAY, GA
    ZIP 31032
  • Facility Phone: 478 986-3066
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: IHAB Z. ZAGGOUT
  • NPI Number: 1629464797
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1061298
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DSI MACON, LLC D/B/A US RENAL CARE GRAY DIALYSIS
Street 1002 BOULDER DRIVE
City GRAY
State GA
ZIP 31032
Phone 478 986-3066
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director IHAB Z. ZAGGOUT

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