11D2000448 CLIA NUMBER - CONYERS DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D2000448
  • Facility Name: CONYERS DIALYSIS
  • Facility Address: 1501 MILSTEAD ROAD NE, SUITE 150
    CONYERS, GA
    ZIP 30012
  • Facility Phone: 770 761-8097
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MAZEN ABDALLA
  • NPI Number: 1720314776
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2000448
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name CONYERS DIALYSIS
Street 1501 MILSTEAD ROAD NE, SUITE 150
City CONYERS
State GA
ZIP 30012
Phone 770 761-8097
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2023
Certificate Expiration Date 11/30/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MAZEN ABDALLA

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