11D1002109 CLIA NUMBER - PROFESSIONAL EYE ASSOCIATES INC

Laboratory Demographics

  • CLIA Code: 11D1002109
  • Facility Name: PROFESSIONAL EYE ASSOCIATES INC
  • Facility Address: 1111 PROFESSIONAL BOULEVARD
    DALTON, GA
    ZIP 30720
  • Facility Phone: 706 226-2020
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TIMOTHY E. O BOYLE
  • NPI Number: 1174988232
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 11D1002109
LAB Type Ambulatory Surgery Center
Facility Name PROFESSIONAL EYE ASSOCIATES INC
Street 1111 PROFESSIONAL BOULEVARD
City DALTON
State GA
ZIP 30720
Phone 706 226-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Ambulatory Surgery Center
Lab Director TIMOTHY E. O BOYLE

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