39D2052757 CLIA NUMBER - VISTARUA EYE

Laboratory Demographics

  • CLIA Code: 39D2052757
  • Facility Name: VISTARUA EYE
  • Facility Address: 10 CAPITAL DRIVE SUITE 300
    HARRISBURG, PA
    ZIP 17110
  • Facility Phone: (717) 233-3937
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. GAUTAM MISHRA MD
  • NPI Number: 1114950144
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 39D2052757
LAB Type Physician Office
Facility Name VISTARUA EYE
Street 10 CAPITAL DRIVE SUITE 300
City HARRISBURG
State PA
ZIP 17110
Phone 7172333937
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type Physician Office
Lab Director DR. GAUTAM MISHRA MD

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This page was last updated on: 5/15/2026