11D2263001 CLIA NUMBER - ADVANCED EYE OF MARIETTA

Laboratory Demographics

  • CLIA Code: 11D2263001
  • Facility Name: ADVANCED EYE OF MARIETTA
  • Facility Address: 2645 DALLAS HIGHWAY, SUITE 100
    MARIETTA, GA
    ZIP 30064
  • Facility Phone: 770 422-8002
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALFRED M. LONG
  • NPI Number: 1720217771
  • Taxonomy: 152WC0802X - Optometrist

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Physician Office
Lab Director ALFRED M. LONG

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