11D2264328 CLIA NUMBER - CHILDREN'S HEALTHCARE OF ATLANTA NEPHROLOGY AT FAYETTE

Laboratory Demographics

  • CLIA Code: 11D2264328
  • Facility Name: CHILDREN'S HEALTHCARE OF ATLANTA NEPHROLOGY AT FAYETTE
  • Facility Address: 1250 HIGHWAY 54 SUITE 200
    FAYETTEVILLE, GA
    ZIP 30214
  • Facility Phone: (404) 785-5437
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: LAURENCE GREENBAUM
  • NPI Number: 1689744450
  • Taxonomy: 282NC2000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 11D2264328
LAB Type Ancillary Testing Site in Health Care Center
Facility Name CHILDREN'S HEALTHCARE OF ATLANTA NEPHROLOGY AT FAYETTE
Street 1250 HIGHWAY 54 SUITE 200
City FAYETTEVILLE
State GA
ZIP 30214
Phone 4047855437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2024
Certificate Expiration Date 7/12/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director LAURENCE GREENBAUM

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This page was last updated on: 5/15/2026