11D2172428 CLIA NUMBER - WINDERMERE DIALYSIS

Laboratory Demographics

  • CLIA Code: 11D2172428
  • Facility Name: WINDERMERE DIALYSIS
  • Facility Address: 3015 THE COMMONS DRIVE
    CUMMING, GA
    ZIP 30041
  • Facility Phone: 770 205-3289
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SOHAIL EJAZ
  • NPI Number: 1538711288
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2172428
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name WINDERMERE DIALYSIS
Street 3015 THE COMMONS DRIVE
City CUMMING
State GA
ZIP 30041
Phone 770 205-3289
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2025
Certificate Expiration Date 9/23/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SOHAIL EJAZ

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