CLIA lab
CLIA 11D2124236: Tara Boulevard Dialysis
Jonesboro, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2124236 belongs to Tara Boulevard Dialysis in Jonesboro, GA.
Certificate of Waiver, effective January 12, 2025, expires January 11, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- January 12, 2025
- Certificate expiration
- January 11, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 12, 2017
- Facility type
- End stage renal disease dialysis facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D2124236
- Lab name
- Tara Boulevard Dialysis
- Address
- 6540 Tara Blvd, Suite 200, Jonesboro, GA 30236
- Phone
- (770) 968-8429
- Fax
- (770) 968-8744
Annual test volume the lab reported
- Waived tests
- 21,528
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- DaVita Tara Boulevard DialysisCMS Care Compare ratings for the facility at the same street address
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Related
Questions
What is the CLIA number for Tara Boulevard Dialysis in Jonesboro?
11D2124236, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Tara Boulevard Dialysis hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2124236 expire?
The CMS file lists January 11, 2027 as the certificate expiration date; the certificate took effect January 12, 2025.