11D2102615 CLIA NUMBER - FRESENIUS MEDICAL CARE AUGUSTA HOME

Laboratory Demographics

CLIA Number: 11D2102615

Facility Name: FRESENIUS MEDICAL CARE AUGUSTA HOME

Facility Address:
2470 WRIGHTSBORO ROAD
AUGUSTA, GA
ZIP 30904
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Facility Phone Number: 706 481-6920

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1225412513

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2102615
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE AUGUSTA HOME
Street	2470 WRIGHTSBORO ROAD
City	AUGUSTA
State	GA
ZIP	30904
Phone	706 481-6920
CertificateType	4
CertificateEffectiveDate	9/25/2023
CertificateExpirationDate	9/24/2025
FacilityType	Waiver

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