11D2142051 CLIA NUMBER - JESSE JEWELL DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D2142051
  • Facility Name: JESSE JEWELL DIALYSIS
  • Facility Address: 1475 JESSE JEWELL PARKWAY , NE
    GAINESVILLE, GA
    ZIP 30501
  • Facility Phone: 404 819-1154
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: LAURA SHEPERD
  • NPI Number: 1477063543
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2142051
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name JESSE JEWELL DIALYSIS
Street 1475 JESSE JEWELL PARKWAY , NE
City GAINESVILLE
State GA
ZIP 30501
Phone 404 819-1154
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director LAURA SHEPERD

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