11D1075261 CLIA NUMBER - UNION CITY DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D1075261
  • Facility Name: UNION CITY DIALYSIS
  • Facility Address: 6851 SHANNON PARKWAY SUITE 200
    UNION CITY, GA
    ZIP 30291
  • Facility Phone: 770 774-9300
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JERRY D. COOPER MD
  • NPI Number: 1396930400
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1075261
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name UNION CITY DIALYSIS
Street 6851 SHANNON PARKWAY SUITE 200
City UNION CITY
State GA
ZIP 30291
Phone 770 774-9300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JERRY D. COOPER MD

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