49D2306276 CLIA NUMBER - BALLSTON OPTOMETRY, LLC

Laboratory Demographics

  • CLIA Code: 49D2306276
  • Facility Name: BALLSTON OPTOMETRY, LLC
  • Facility Address: 4121 WILSON BLVD, SUITE 100
    ARLINGTON, VA
    ZIP 22203
  • Facility Phone: 703 847-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHEAL DAVIDSON
  • NPI Number: 1083779094
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 49D2306276
LAB Type Physician Office
Facility Name BALLSTON OPTOMETRY, LLC
Street 4121 WILSON BLVD, SUITE 100
City ARLINGTON
State VA
ZIP 22203
Phone 703 847-8899
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2024
Certificate Expiration Date 6/13/2026
Facility Type Physician Office
Lab Director MICHEAL DAVIDSON

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