11D1099648 CLIA NUMBER - ATEKHA NEPHROLOGY CLINIC

Laboratory Demographics

  • CLIA Code: 11D1099648
  • Facility Name: ATEKHA NEPHROLOGY CLINIC
  • Facility Address: 1030 BERMUDA RUN ROAD
    STATESBORO, GA
    ZIP 30458
  • Facility Phone: 912 764-8396
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: COURAGE A. ATEKHA
  • NPI Number: 1285767434
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1099648
LAB Type Physician Office
Facility Name ATEKHA NEPHROLOGY CLINIC
Street 1030 BERMUDA RUN ROAD
City STATESBORO
State GA
ZIP 30458
Phone 912 764-8396
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2025
Certificate Expiration Date 5/18/2027
Facility Type Physician Office
Lab Director COURAGE A. ATEKHA

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