11D2108430 CLIA NUMBER - GEORGIA RENAL AND HYPERTENSION CARE

Laboratory Demographics

CLIA Number: 11D2108430

Facility Name: GEORGIA RENAL AND HYPERTENSION CARE

Facility Address:
2326 HWY 34 EAST, SUITE 201
NEWNAN, GA
ZIP 30265
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Facility Phone Number: 678 664-1545

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1932591948

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	11D2108430
LAB Type	Physician Office
Facility Name	GEORGIA RENAL AND HYPERTENSION CARE
Street	2326 HWY 34 EAST, SUITE 201
City	NEWNAN
State	GA
ZIP	30265
Phone	678 664-1545
CertificateType	4
CertificateEffectiveDate	1/17/2023
CertificateExpirationDate	1/16/2025
FacilityType	Waiver

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