49D2079294 CLIA NUMBER - MID ATLANTIC EYECARE

Laboratory Demographics

  • CLIA Code: 49D2079294
  • Facility Name: MID ATLANTIC EYECARE
  • Facility Address: 6161 KEMPSVILLE CIRCLE - SUITE 130
    NORFOLK, VA
    ZIP 23502
  • Facility Phone: 757 455-5130
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FREDRIC J. GROSS
  • NPI Number: 1235594524
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 49D2079294
LAB Type Physician Office
Facility Name MID ATLANTIC EYECARE
Street 6161 KEMPSVILLE CIRCLE - SUITE 130
City NORFOLK
State VA
ZIP 23502
Phone 757 455-5130
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2024
Certificate Expiration Date 6/12/2026
Facility Type Physician Office
Lab Director FREDRIC J. GROSS

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