11D2080146 CLIA NUMBER - CANTON EYE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D2080146
  • Facility Name: CANTON EYE SURGERY CENTER
  • Facility Address: 201 KIMBERLY WAY, SUITE 104 ATTN DONNA WALTON
    CANTON, GA
    ZIP 30114
  • Facility Phone: 678 381-2020
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MILAN R. PATEL
  • NPI Number: 1992122329
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2080146
LAB Type Ambulatory Surgery Center
Facility Name CANTON EYE SURGERY CENTER
Street 201 KIMBERLY WAY, SUITE 104 ATTN DONNA WALTON
City CANTON
State GA
ZIP 30114
Phone 678 381-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Ambulatory Surgery Center
Lab Director MILAN R. PATEL

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