11D2037114 CLIA NUMBER - FRESENIUS MEDICAL CARE ACWORTH

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Laboratory Demographics

CLIA Number: 11D2037114

Facility Name: FRESENIUS MEDICAL CARE ACWORTH

Facility Address:
3372 ACWORTH SUMMITT BLVD
ACWORTH, GA
ZIP 30101
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Facility Phone Number: 770 428-3538

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1851671507

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2037114
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE ACWORTH
Street	3372 ACWORTH SUMMITT BLVD
City	ACWORTH
State	GA
ZIP	30101
Phone	770 428-3538
CertificateType	4
CertificateEffectiveDate	2/21/2024
CertificateExpirationDate	2/20/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024