11D2157181 CLIA NUMBER - POPLAR DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D2157181
  • Facility Name: POPLAR DIALYSIS
  • Facility Address: 2301 NEWNAN CROSSING BLVD, SUITE 180
    NEWNAN, GA
    ZIP 30265
  • Facility Phone: 770 253-2403
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: VISHAL RATKALKAR
  • NPI Number: 1003311341
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2157181
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name POPLAR DIALYSIS
Street 2301 NEWNAN CROSSING BLVD, SUITE 180
City NEWNAN
State GA
ZIP 30265
Phone 770 253-2403
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director VISHAL RATKALKAR

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