49D2321393 CLIA NUMBER - SOUTHEASTERN RETINA ASSOCIATES PC

Laboratory Demographics

  • CLIA Code: 49D2321393
  • Facility Name: SOUTHEASTERN RETINA ASSOCIATES PC
  • Facility Address: 109 GATE CITY HIGHWAY
    BRISTOL, VA
    ZIP 24201
  • Facility Phone: 423 578-4364
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK E. KLEINMAN
  • NPI Number: 1932370145
  • Taxonomy: 207WX0107X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 49D2321393
LAB Type Physician Office
Facility Name SOUTHEASTERN RETINA ASSOCIATES PC
Street 109 GATE CITY HIGHWAY
City BRISTOL
State VA
ZIP 24201
Phone 423 578-4364
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Physician Office
Lab Director MARK E. KLEINMAN

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