11D2273811 CLIA NUMBER - GEORGIA EYE SURGERY, LLC

Laboratory Demographics

  • CLIA Code: 11D2273811
  • Facility Name: GEORGIA EYE SURGERY, LLC
  • Facility Address: 1620 PRINCE AVENUE SUITE B
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 706 546-0170
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: CENTRAEL T. EVANS
  • NPI Number: 1720602683
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2273811
LAB Type Ambulatory Surgery Center
Facility Name GEORGIA EYE SURGERY, LLC
Street 1620 PRINCE AVENUE SUITE B
City ATHENS
State GA
ZIP 30606
Phone 706 546-0170
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Ambulatory Surgery Center
Lab Director CENTRAEL T. EVANS

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