21D2305250 CLIA NUMBER - HYATTSVILLE OPTOMETRY LLC

Laboratory Demographics

  • CLIA Code: 21D2305250
  • Facility Name: HYATTSVILLE OPTOMETRY LLC
  • Facility Address: 5331 BALTIMORE AVE STE 103
    HYATTSVILLE, MD
    ZIP 20781
  • Facility Phone: 703 847-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VINCENT BERTOMEU
  • NPI Number: 1174884126
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 21D2305250
LAB Type Physician Office
Facility Name HYATTSVILLE OPTOMETRY LLC
Street 5331 BALTIMORE AVE STE 103
City HYATTSVILLE
State MD
ZIP 20781
Phone 703 847-8899
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2024
Certificate Expiration Date 5/28/2026
Facility Type Physician Office
Lab Director VINCENT BERTOMEU

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