10D1030197 CLIA NUMBER - ATLANTIC EYE CENTER

Laboratory Demographics

CLIA Number: 10D1030197

Facility Name: ATLANTIC EYE CENTER

Facility Address:
3 PINE CONE DR STE 104
PALM COAST, FL
ZIP 32137
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Facility Phone Number: 386 446-9590

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1316388978

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1030197
LAB Type	Physician Office
Facility Name	ATLANTIC EYE CENTER
Street	3 PINE CONE DR STE 104
City	PALM COAST
State	FL
ZIP	32137
Phone	386 446-9590
CertificateType	4
CertificateEffectiveDate	7/30/2023
CertificateExpirationDate	7/29/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024