11D2071621 CLIA NUMBER - MARIETTA EYE CLINIC

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CLIA Record

Field Name Field Value
CLIA Number 11D2071621
LAB Type Physician Office
Facility Name MARIETTA EYE CLINIC
Street 8841 HOSPITAL DRIVE
City DOUGLASVILLE
State GA
ZIP 30134
Phone 770 577-2220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Physician Office
Lab Director ANDRE S. COHEN

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