11D1078767 CLIA NUMBER - FRESENIUS KIDNEY CARE CHATTOOGA COUNTY

Laboratory Demographics

CLIA Number: 11D1078767

Facility Name: FRESENIUS KIDNEY CARE CHATTOOGA COUNTY

Facility Address:
12541 HIGHWAY 27
SUMMERVILLE, GA
ZIP 30747
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Facility Phone Number: 706 234-6905

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1053823864

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D1078767
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS KIDNEY CARE CHATTOOGA COUNTY
Street	12541 HIGHWAY 27
City	SUMMERVILLE
State	GA
ZIP	30747
Phone	706 234-6905
CertificateType	4
CertificateEffectiveDate	1/16/2024
CertificateExpirationDate	1/15/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024