49D2058976 CLIA NUMBER - TIDEWATER EYE CENTERS

Laboratory Demographics

  • CLIA Code: 49D2058976
  • Facility Name: TIDEWATER EYE CENTERS
  • Facility Address: 3235 ACADEMY AVENUE
    PORTSMOUTH, VA
    ZIP 23703
  • Facility Phone: (757) 483-0400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WAYNE R. DEVANTIER
  • NPI Number: 1245469964
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 49D2058976
LAB Type Physician Office
Facility Name TIDEWATER EYE CENTERS
Street 3235 ACADEMY AVENUE
City PORTSMOUTH
State VA
ZIP 23703
Phone 7574830400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Physician Office
Lab Director WAYNE R. DEVANTIER

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This page was last updated on: 5/18/2026