11D0960345 CLIA NUMBER - EYE ASSOCIATES SURGERY CENTER

Laboratory Demographics

CLIA Number: 11D0960345

Facility Name: EYE ASSOCIATES SURGERY CENTER

Facility Address:
3024 NORTH PATTERSON ST
VALDOSTA, GA
ZIP 31602
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Facility Phone Number: 229 247-0557

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1487782637

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D0960345
LAB Type	Ambulatory Surgery Center
Facility Name	EYE ASSOCIATES SURGERY CENTER
Street	3024 NORTH PATTERSON ST
City	VALDOSTA
State	GA
ZIP	31602
Phone	229 247-0557
CertificateType	4
CertificateEffectiveDate	5/7/2023
CertificateExpirationDate	5/6/2025
FacilityType	Waiver

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