11D2065715 CLIA NUMBER - VICTORY DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D2065715
  • Facility Name: VICTORY DIALYSIS
  • Facility Address: 2401 SHELBY STREET
    COLUMBUS, GA
    ZIP 31903
  • Facility Phone: 706 682-5327
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. TAMORIE SMITH
  • NPI Number: 1689008740
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2065715
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name VICTORY DIALYSIS
Street 2401 SHELBY STREET
City COLUMBUS
State GA
ZIP 31903
Phone 706 682-5327
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2025
Certificate Expiration Date 9/12/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. TAMORIE SMITH

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