11D1090382 CLIA NUMBER - GEORGIA RENAL ASSOCIATES PC

Laboratory Demographics

CLIA Number: 11D1090382

Facility Name: GEORGIA RENAL ASSOCIATES PC

Facility Address:
1500 OGLETHORPE AVE, SUITE 500C
ATHENS, GA
ZIP 30606
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Facility Phone Number: 706 546-7484

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1780851436

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	11D1090382
LAB Type	Physician Office
Facility Name	GEORGIA RENAL ASSOCIATES PC
Street	1500 OGLETHORPE AVE, SUITE 500C
City	ATHENS
State	GA
ZIP	30606
Phone	706 546-7484
CertificateType	4
CertificateEffectiveDate	10/9/2022
CertificateExpirationDate	10/8/2024
FacilityType	Waiver

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