21D2070201 CLIA NUMBER - POTOMAC EYE SURGEONS PA

Laboratory Demographics

  • CLIA Code: 21D2070201
  • Facility Name: POTOMAC EYE SURGEONS PA
  • Facility Address: 11500 LAKE POTOMAC DRIVE
    POTOMAC, MD
    ZIP 20854
  • Facility Phone: 301 299-5666
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAURIE WENGER
  • NPI Number: 1194914333
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 21D2070201
LAB Type Physician Office
Facility Name POTOMAC EYE SURGEONS PA
Street 11500 LAKE POTOMAC DRIVE
City POTOMAC
State MD
ZIP 20854
Phone 301 299-5666
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2024
Certificate Expiration Date 8/12/2026
Facility Type Physician Office
Lab Director LAURIE WENGER

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