21D2317995 CLIA NUMBER - ELDERSBURG OPTOMETRY LLC

Laboratory Demographics

  • CLIA Code: 21D2317995
  • Facility Name: ELDERSBURG OPTOMETRY LLC
  • Facility Address: 1311 LONDONTOWN BLVD #100
    ELDERSBURG, MD
    ZIP 21784
  • Facility Phone: 703 847-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VINCENT A. BERTOMEU
  • NPI Number: 1407906605
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 21D2317995
LAB Type Physician Office
Facility Name ELDERSBURG OPTOMETRY LLC
Street 1311 LONDONTOWN BLVD #100
City ELDERSBURG
State MD
ZIP 21784
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 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Physician Office
Lab Director VINCENT A. BERTOMEU

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