21D2312626 CLIA NUMBER - KENTLANDS OPTOMETRY LLC

Laboratory Demographics

  • CLIA Code: 21D2312626
  • Facility Name: KENTLANDS OPTOMETRY LLC
  • Facility Address: 80 MARKET ST
    GAITHERSBURG, MD
    ZIP 20878
  • Facility Phone: 703 847-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VINCENT BERTOMEU
  • NPI Number: 1275774234
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 21D2312626
LAB Type Physician Office
Facility Name KENTLANDS OPTOMETRY LLC
Street 80 MARKET ST
City GAITHERSBURG
State MD
ZIP 20878
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 10/16/2024
Certificate Expiration Date 10/15/2026
Facility Type Physician Office
Lab Director VINCENT BERTOMEU

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