11D2071854 CLIA NUMBER - EMORY DIALYSIS SAINT JOSEPH'S

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Laboratory Demographics

CLIA Number: 11D2071854

Facility Name: EMORY DIALYSIS SAINT JOSEPH'S

Facility Address:
5673 PEACHTREE DUNWOODY RD NE SUITE 501
ATLANTA, GA
ZIP 30342
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Facility Phone Number: 404 778-8075

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1477985992

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2071854
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	EMORY DIALYSIS SAINT JOSEPH'S
Street	5673 PEACHTREE DUNWOODY RD NE SUITE 501
City	ATLANTA
State	GA
ZIP	30342
Phone	404 778-8075
CertificateType	4
CertificateEffectiveDate	1/21/2024
CertificateExpirationDate	1/20/2026
FacilityType	Waiver

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