25D2000813 CLIA NUMBER - PROFESSIONAL EYECARE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 25D2000813
  • Facility Name: PROFESSIONAL EYECARE ASSOCIATES
  • Facility Address: 6704 OLD CANTON ROAD
    RIDGELAND, MS
    ZIP 39157
  • Facility Phone: 601 957-9292
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM B. CRAIG
  • NPI Number: 1497830020
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 25D2000813
LAB Type Physician Office
Facility Name PROFESSIONAL EYECARE ASSOCIATES
Street 6704 OLD CANTON ROAD
City RIDGELAND
State MS
ZIP 39157
Phone 601 957-9292
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2023
Certificate Expiration Date 12/6/2025
Facility Type Physician Office
Lab Director WILLIAM B. CRAIG

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