11D2263001 CLIA NUMBER - ADVANCED EYE OF MARIETTA

Laboratory Demographics

CLIA Number: 11D2263001

Facility Name: ADVANCED EYE OF MARIETTA

Facility Address:
2645 DALLAS HIGHWAY, SUITE 100
MARIETTA, GA
ZIP 30064
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Facility Phone Number: 770 422-8002

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1720217771

Taxonomy: 152WC0802X - Optometrist
The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear.

CLIA Record

Field Name	Field Value
CLIA Number	11D2263001
LAB Type	Physician Office
Facility Name	ADVANCED EYE OF MARIETTA
Street	2645 DALLAS HIGHWAY, SUITE 100
City	MARIETTA
State	GA
ZIP	30064
Phone	770 422-8002
CertificateType	4
CertificateEffectiveDate	6/22/2022
CertificateExpirationDate	6/21/2024
FacilityType	Waiver

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