49D2306278 CLIA NUMBER - CENTREVILLE OPTOMETRY, LLC

Laboratory Demographics

  • CLIA Code: 49D2306278
  • Facility Name: CENTREVILLE OPTOMETRY, LLC
  • Facility Address: 14245E CENTREVILLE SQ
    CENTREVILLE, VA
    ZIP 20121
  • Facility Phone: 703 847-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHEAL DAVIDSON
  • NPI Number: 1306037734
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 49D2306278
LAB Type Physician Office
Facility Name CENTREVILLE OPTOMETRY, LLC
Street 14245E CENTREVILLE SQ
City CENTREVILLE
State VA
ZIP 20121
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