11D2141039 CLIA NUMBER - EAGLES LANDING DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D2141039
  • Facility Name: EAGLES LANDING DIALYSIS
  • Facility Address: 270 VILLAGE CENTER PARKWAY
    STOCKBRIDGE, GA
    ZIP 30281
  • Facility Phone: 770 389-8255
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JANICE L. WEATHERSPOON
  • NPI Number: 1528584448
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2141039
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name EAGLES LANDING DIALYSIS
Street 270 VILLAGE CENTER PARKWAY
City STOCKBRIDGE
State GA
ZIP 30281
Phone 770 389-8255
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2023
Certificate Expiration Date 12/5/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JANICE L. WEATHERSPOON

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