11D1090382 CLIA NUMBER - GEORGIA RENAL ASSOCIATES PC

Laboratory Demographics

  • CLIA Code: 11D1090382
  • Facility Name: GEORGIA RENAL ASSOCIATES PC
  • Facility Address: 1500 OGLETHORPE AVE, SUITE 500C
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 706 546-7484
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: REBALA SRILAKSHMI MD
  • NPI Number: 1780851436
  • Taxonomy: 207RN0300X - Internal Medicine

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2024
Certificate Expiration Date 10/8/2026
Facility Type Physician Office
Lab Director REBALA SRILAKSHMI MD

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