11D2116810 CLIA NUMBER - TOWN PARK DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D2116810
  • Facility Name: TOWN PARK DIALYSIS
  • Facility Address: 401 TOWN PARK BLVD
    EVANS, GA
    ZIP 30809
  • Facility Phone: 706 854-9502
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ROBERT J. SHAY
  • NPI Number: 1770939118
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2116810
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name TOWN PARK DIALYSIS
Street 401 TOWN PARK BLVD
City EVANS
State GA
ZIP 30809
Phone 706 854-9502
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ROBERT J. SHAY

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