42D2075411 CLIA NUMBER - INDIGO VISION CENTER

Laboratory Demographics

  • CLIA Code: 42D2075411
  • Facility Name: INDIGO VISION CENTER
  • Facility Address: 302 CHURCH STREET
    GEORGETOWN, SC
    ZIP 29440
  • Facility Phone: 843 546-2244
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OWEN JOHNSON
  • NPI Number: 1700071149
  • Taxonomy: 152W00000X - Optometrist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2075411
LAB Type Physician Office
Facility Name INDIGO VISION CENTER
Street 302 CHURCH STREET
City GEORGETOWN
State SC
ZIP 29440
Phone 843 546-2244
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2024
Certificate Expiration Date 3/26/2026
Facility Type Physician Office
Lab Director OWEN JOHNSON

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: 9/29/2025