11D2175578 CLIA NUMBER - EAST ATLANTA EYE SURGERY CENTER, LLC

Laboratory Demographics

CLIA Number: 11D2175578

Facility Name: EAST ATLANTA EYE SURGERY CENTER, LLC

Facility Address:
550 PROFESSIONAL DRIVE
LAWRENCEVILLE, GA
ZIP 30046
Get Directions

Facility Phone Number: 678 372-9457

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1861029712

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2175578
LAB Type	Ambulatory Surgery Center
Facility Name	EAST ATLANTA EYE SURGERY CENTER, LLC
Street	550 PROFESSIONAL DRIVE
City	LAWRENCEVILLE
State	GA
ZIP	30046
Phone	678 372-9457
CertificateType	4
CertificateEffectiveDate	11/25/2023
CertificateExpirationDate	11/24/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024