22D2194624 CLIA NUMBER - BAY STATE EXCELLENT VISION

Laboratory Demographics

  • CLIA Code: 22D2194624
  • Facility Name: BAY STATE EXCELLENT VISION
  • Facility Address: 3 WOODLAND RD STE 112
    STONEHAM, MA
    ZIP 02180
  • Facility Phone: 781 321-6463
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDWARD JACCOMA
  • NPI Number: 1437597424
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 22D2194624
LAB Type Physician Office
Facility Name BAY STATE EXCELLENT VISION
Street 3 WOODLAND RD STE 112
City STONEHAM
State MA
ZIP 02180
Phone 781 321-6463
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Physician Office
Lab Director EDWARD JACCOMA

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