01D2113682 CLIA NUMBER - EYE SURGICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 01D2113682
  • Facility Name: EYE SURGICAL ASSOCIATES
  • Facility Address: 2664 HARTFORD HWY
    DOTHAN, AL
    ZIP 36305
  • Facility Phone: 334 699-2244
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN K. WALLACE MD
  • NPI Number: 1669648879
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 01D2113682
LAB Type Physician Office
Facility Name EYE SURGICAL ASSOCIATES
Street 2664 HARTFORD HWY
City DOTHAN
State AL
ZIP 36305
Phone 334 699-2244
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/27/2024
Certificate Expiration Date 5/26/2026
Facility Type Physician Office
Lab Director JOHN K. WALLACE MD

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