39D2110412 CLIA NUMBER - ANTIETAM EYE

Laboratory Demographics

  • CLIA Code: 39D2110412
  • Facility Name: ANTIETAM EYE
  • Facility Address: 1051 E MAIN STREET, UNIT 7
    WAYNESBORO, PA
    ZIP 17268
  • Facility Phone: 717 387-5657
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ALISON S. RIDENOUR
  • NPI Number: 1972733459
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 39D2110412
LAB Type Physician Office
Facility Name ANTIETAM EYE
Street 1051 E MAIN STREET, UNIT 7
City WAYNESBORO
State PA
ZIP 17268
Phone 717 387-5657
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Physician Office
Lab Director DR. ALISON S. RIDENOUR

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