11D2119125 CLIA NUMBER - DSI SNELLVILLE, LLC DBA U S RENAL CARE SNELLVILLE DIALYSIS

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Laboratory Demographics

CLIA Number: 11D2119125

Facility Name: DSI SNELLVILLE, LLC DBA U S RENAL CARE SNELLVILLE DIALYSIS

Facility Address:
3370 SUGARLOAF PARKWAY
LAWRENCEVILLE, GA
ZIP 30044
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Facility Phone Number: 770 225-0827

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1952859209

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2119125
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DSI SNELLVILLE, LLC DBA U S RENAL CARE SNELLVILLE DIALYSIS
Street	3370 SUGARLOAF PARKWAY
City	LAWRENCEVILLE
State	GA
ZIP	30044
Phone	770 225-0827
CertificateType	4
CertificateEffectiveDate	9/20/2022
CertificateExpirationDate	9/19/2024
FacilityType	Waiver

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