15D2122069 CLIA NUMBER - EYE ASSOCIATES OF S IND PC

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Laboratory Demographics

CLIA Number: 15D2122069

Facility Name: EYE ASSOCIATES OF S IND PC

Facility Address:
1356 N GARDNER ST
SCOTTSBURG, IN
ZIP 47170
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Facility Phone Number: 812 284-0660

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1952712101

Taxonomy: 332H00000X - Eyewear Supplier
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

CLIA Record

Field Name	Field Value
CLIA Number	15D2122069
LAB Type	Physician Office
Facility Name	EYE ASSOCIATES OF S IND PC
Street	1356 N GARDNER ST
City	SCOTTSBURG
State	IN
ZIP	47170
Phone	812 284-0660
CertificateType	4
CertificateEffectiveDate	11/18/2022
CertificateExpirationDate	11/17/2024
FacilityType	Waiver

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