11D2112446 CLIA NUMBER - PROFESSIONAL EYE CARE

Laboratory Demographics

  • CLIA Code: 11D2112446
  • Facility Name: PROFESSIONAL EYE CARE
  • Facility Address: 214 SAVANNAH AVENUE
    STATESBORO, GA
    ZIP 30458
  • Facility Phone: 912 764-5609
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: HORACE DEAL
  • NPI Number: 1225199979
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 11D2112446
LAB Type Practitioner Other
Facility Name PROFESSIONAL EYE CARE
Street 214 SAVANNAH AVENUE
City STATESBORO
State GA
ZIP 30458
Phone 912 764-5609
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2024
Certificate Expiration Date 4/28/2026
Facility Type Practitioner Other
Lab Director HORACE DEAL

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