36D1039036 CLIA NUMBER - EYE SURGICAL CENTER LLC

Laboratory Demographics

CLIA Number: 36D1039036

Facility Name: EYE SURGICAL CENTER LLC

Facility Address:
800 MCKINLEY AVENUE NW
CANTON, OH
ZIP 44703
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Facility Phone Number: 330 452-8884

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1306885256

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D1039036
LAB Type	Ambulatory Surgery Center
Facility Name	EYE SURGICAL CENTER LLC
Street	800 MCKINLEY AVENUE NW
City	CANTON
State	OH
ZIP	44703
Phone	330 452-8884
CertificateType	4
CertificateEffectiveDate	4/4/2023
CertificateExpirationDate	4/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024