11D2135810 CLIA NUMBER - MARIETTA EYE CLINIC, PA

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CLIA Record

Field Name Field Value
CLIA Number 11D2135810
LAB Type Physician Office
Facility Name MARIETTA EYE CLINIC, PA
Street 2990 EAGLE DRIVE, SUITE 110
City WOODSTOCK
State GA
ZIP 30189
Phone 678 460-4810
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Physician Office
Lab Director ANDRE S. COHEN

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