11D2074765 CLIA NUMBER - ATHENS RENAL CENTER, LLC

Laboratory Demographics

  • CLIA Code: 11D2074765
  • Facility Name: ATHENS RENAL CENTER, LLC
  • Facility Address: 2047 PRINCE AVENUE, SUITE A
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 706 549-2133
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SRILAKSHMI REBALA
  • NPI Number: 1912320631
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2074765
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ATHENS RENAL CENTER, LLC
Street 2047 PRINCE AVENUE, SUITE A
City ATHENS
State GA
ZIP 30606
Phone 706 549-2133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SRILAKSHMI REBALA

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