19D2050894 CLIA NUMBER - WALLACE EYE SURGERY

Laboratory Demographics

  • CLIA Code: 19D2050894
  • Facility Name: WALLACE EYE SURGERY
  • Facility Address: 4110 PARLIAMENT DRIVE
    ALEXANDRIA, LA
    ZIP 71303
  • Facility Phone: 318 448-4488
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT T. CROTTY
  • NPI Number: 1679511679
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 19D2050894
LAB Type Physician Office
Facility Name WALLACE EYE SURGERY
Street 4110 PARLIAMENT DRIVE
City ALEXANDRIA
State LA
ZIP 71303
Phone 318 448-4488
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Physician Office
Lab Director ROBERT T. CROTTY

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