11D2003617 CLIA NUMBER - MAGNOLIA OAKS DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D2003617
  • Facility Name: MAGNOLIA OAKS DIALYSIS
  • Facility Address: 2377 HIGHWAY 196 W
    HINESVILLE, GA
    ZIP 31313
  • Facility Phone: 912 368-2710
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ESKANDAR NIZAR
  • NPI Number: 1508175464
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2003617
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MAGNOLIA OAKS DIALYSIS
Street 2377 HIGHWAY 196 W
City HINESVILLE
State GA
ZIP 31313
Phone 912 368-2710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2024
Certificate Expiration Date 2/14/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ESKANDAR NIZAR

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