21D2305255 CLIA NUMBER - PRINCE FREDERICK OPTOMETRY LLC

Laboratory Demographics

  • CLIA Code: 21D2305255
  • Facility Name: PRINCE FREDERICK OPTOMETRY LLC
  • Facility Address: 130 W DARES BEACH ROAD
    PRINCE FREDERICK, MD
    ZIP 20678
  • Facility Phone: 703 847-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VINCENT A. BERTOMEU
  • NPI Number: 1437590502
  • Taxonomy: 152W00000X - Optometrist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2305255
LAB Type Physician Office
Facility Name PRINCE FREDERICK OPTOMETRY LLC
Street 130 W DARES BEACH ROAD
City PRINCE FREDERICK
State MD
ZIP 20678
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 A. BERTOMEU

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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