11D2116766 CLIA NUMBER - BRASELTON DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D2116766
  • Facility Name: BRASELTON DIALYSIS
  • Facility Address: 1241 FRIENDSHIP RD, STE 130
    BRASELTON, GA
    ZIP 30517
  • Facility Phone: 770 965-6058
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. TRAN T. KIM
  • NPI Number: 1588284426
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2116766
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BRASELTON DIALYSIS
Street 1241 FRIENDSHIP RD, STE 130
City BRASELTON
State GA
ZIP 30517
Phone 770 965-6058
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2024
Certificate Expiration Date 7/31/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. TRAN T. KIM

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