40D2299687 CLIA NUMBER - SOUTHERN RETINA CONSULTANTS, PSC

Laboratory Demographics

  • CLIA Code: 40D2299687
  • Facility Name: SOUTHERN RETINA CONSULTANTS, PSC
  • Facility Address: TORRE MEDICA SAN LUCAS 909 AVE TITO CASTRO STE 709
    PONCE, PR
    ZIP 00716
  • Facility Phone: 787 842-2512
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JORGE GUTIERREZ DORRINGTON
  • NPI Number: 1154314292
  • Taxonomy: 207W00000X - Ophthalmology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 40D2299687
LAB Type Physician Office
Facility Name SOUTHERN RETINA CONSULTANTS, PSC
Street TORRE MEDICA SAN LUCAS 909 AVE TITO CASTRO STE 709
City PONCE
State PR
ZIP 00716
Phone 787 842-2512
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2024
Certificate Expiration Date 2/25/2026
Facility Type Physician Office
Lab Director JORGE GUTIERREZ DORRINGTON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025