07D2015628 CLIA NUMBER - GREENWICH OPTHALMOLOGY ASSOCIATES, PC

Laboratory Demographics

  • CLIA Code: 07D2015628
  • Facility Name: GREENWICH OPTHALMOLOGY ASSOCIATES, PC
  • Facility Address: 2046 WEST MAIN ST SUITE 2
    STAMFORD, CT
    ZIP 06902
  • Facility Phone: (203) 869-3082
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SURESH MANDAVA MD
  • NPI Number: 1700879004
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 07D2015628
LAB Type Physician Office
Facility Name GREENWICH OPTHALMOLOGY ASSOCIATES, PC
Street 2046 WEST MAIN ST SUITE 2
City STAMFORD
State CT
ZIP 06902
Phone 2038693082
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2024
Certificate Expiration Date 10/28/2026
Facility Type Physician Office
Lab Director SURESH MANDAVA MD

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This page was last updated on: 5/18/2026