21D2328540 CLIA NUMBER - ADVANCED EYE LASER AND SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 21D2328540
  • Facility Name: ADVANCED EYE LASER AND SURGERY CENTER
  • Facility Address: 954 RIDGEBROOK RD STE 300
    SPARKS GLENCOE, MD
    ZIP 21152
  • Facility Phone: 410 618-5640
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SANDEEP PRAMANIK
  • NPI Number: 1174329502
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2328540
LAB Type Ambulatory Surgery Center
Facility Name ADVANCED EYE LASER AND SURGERY CENTER
Street 954 RIDGEBROOK RD STE 300
City SPARKS GLENCOE
State MD
ZIP 21152
Phone 410 618-5640
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Ambulatory Surgery Center
Lab Director SANDEEP PRAMANIK

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