44D0996180 CLIA NUMBER - JACKSON OPHTHALMOLOGY ASC LLC DBA PHYSICIANS SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 44D0996180
  • Facility Name: JACKSON OPHTHALMOLOGY ASC LLC DBA PHYSICIANS SURGERY CENTER
  • Facility Address: 207 STONEBRIDGE BLVD
    JACKSON, TN
    ZIP 38305
  • Facility Phone: 731 661-6340
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SEAN T. NEEL
  • NPI Number: 1053385856
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D0996180
LAB Type Ambulatory Surgery Center
Facility Name JACKSON OPHTHALMOLOGY ASC LLC DBA PHYSICIANS SURGERY CENTER
Street 207 STONEBRIDGE BLVD
City JACKSON
State TN
ZIP 38305
Phone 731 661-6340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2024
Certificate Expiration Date 2/11/2026
Facility Type Ambulatory Surgery Center
Lab Director SEAN T. NEEL

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