11D1099479 CLIA NUMBER - MADISON KIDNEY CENTER

Laboratory Demographics

  • CLIA Code: 11D1099479
  • Facility Name: MADISON KIDNEY CENTER
  • Facility Address: 1311 ATLANTA HIGHWAY SUITE A
    MADISON, GA
    ZIP 30650
  • Facility Phone: 706 752-1113
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: AZUBEZE A. ADOGU
  • NPI Number: 1871680264
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1099479
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MADISON KIDNEY CENTER
Street 1311 ATLANTA HIGHWAY SUITE A
City MADISON
State GA
ZIP 30650
Phone 706 752-1113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director AZUBEZE A. ADOGU

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