11D2178844 CLIA NUMBER - KIDNEY CARE CENTER GWINNETT, LLC

Laboratory Demographics

  • CLIA Code: 11D2178844
  • Facility Name: KIDNEY CARE CENTER GWINNETT, LLC
  • Facility Address: 601 A PROFESSIONAL DRIVE, SUITE 235
    LAWRENCEVILLE, GA
    ZIP 30046
  • Facility Phone: 815 714-7171
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MORUFU ALAUSA
  • NPI Number: 1528267937
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2178844
LAB Type Physician Office
Facility Name KIDNEY CARE CENTER GWINNETT, LLC
Street 601 A PROFESSIONAL DRIVE, SUITE 235
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 815 714-7171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type Physician Office
Lab Director MORUFU ALAUSA

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