11D2069131 CLIA NUMBER - USRC VALDOSTA HOME PROGRAM, LLC

Laboratory Demographics

  • CLIA Code: 11D2069131
  • Facility Name: USRC VALDOSTA HOME PROGRAM, LLC
  • Facility Address: 3564 NORTH CROSSING CIRCLE, SUITE B
    VALDOSTA, GA
    ZIP 31602
  • Facility Phone: 229 671-4298
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ARUNAS URBONAS
  • NPI Number: 1760819601
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2069131
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name USRC VALDOSTA HOME PROGRAM, LLC
Street 3564 NORTH CROSSING CIRCLE, SUITE B
City VALDOSTA
State GA
ZIP 31602
Phone 229 671-4298
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ARUNAS URBONAS

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