11D2167622 CLIA NUMBER - FRESENIUS KIDNEY CARE NORTHEAST ATLANTA, LLC DBA FRESENIUS MEDICAL CARE CANDLER ROAD

Laboratory Demographics

CLIA Number: 11D2167622

Facility Name: FRESENIUS KIDNEY CARE NORTHEAST ATLANTA, LLC DBA FRESENIUS MEDICAL CARE CANDLER ROAD

Facility Address:
2886 MEMORIAL DRIVE, SE
ATLANTA, GA
ZIP 30317
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Facility Phone Number: 770 808-0509

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1538727524

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2167622
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS KIDNEY CARE NORTHEAST ATLANTA, LLC DBA FRESENIUS MEDICAL CARE CANDLER ROAD
Street	2886 MEMORIAL DRIVE, SE
City	ATLANTA
State	GA
ZIP	30317
Phone	770 808-0509
CertificateType	4
CertificateEffectiveDate	6/12/2023
CertificateExpirationDate	6/11/2025
FacilityType	Waiver

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