21D2059183 CLIA NUMBER - EASTON OPTICAL

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Laboratory Demographics

CLIA Number: 21D2059183

Facility Name: EASTON OPTICAL

Facility Address:
210 MARLBORO AVENUE STE 31
EASTON, MD
ZIP 21601
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Facility Phone Number: 410 822-3937

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1780803643

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	21D2059183
LAB Type	Physician Office
Facility Name	EASTON OPTICAL
Street	210 MARLBORO AVENUE STE 31
City	EASTON
State	MD
ZIP	21601
Phone	410 822-3937
CertificateType	4
CertificateEffectiveDate	5/20/2023
CertificateExpirationDate	5/19/2025
FacilityType	Waiver

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