11D1091874 CLIA NUMBER - ARBOR PLACE DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D1091874
  • Facility Name: ARBOR PLACE DIALYSIS
  • Facility Address: 9559 HIGHWAY 5 SUITE 1
    DOUGLASVILLE, GA
    ZIP 30135
  • Facility Phone: 678 391-0993
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ANJUM MOHAMMAD
  • NPI Number: 1740414507
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1091874
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ARBOR PLACE DIALYSIS
Street 9559 HIGHWAY 5 SUITE 1
City DOUGLASVILLE
State GA
ZIP 30135
Phone 678 391-0993
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2024
Certificate Expiration Date 11/12/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ANJUM MOHAMMAD

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