05D2122593 CLIA NUMBER - GRANT OPTOMETRIC GROUP

Laboratory Demographics

  • CLIA Code: 05D2122593
  • Facility Name: GRANT OPTOMETRIC GROUP
  • Facility Address: 3140 BEAR ST
    COSTA MESA, CA
    ZIP 92626
  • Facility Phone: 714 557-2020
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KEVIN GRANT, OD
  • NPI Number: 1316395775
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 05D2122593
LAB Type Practitioner Other
Facility Name GRANT OPTOMETRIC GROUP
Street 3140 BEAR ST
City COSTA MESA
State CA
ZIP 92626
Phone 714 557-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2024
Certificate Expiration Date 11/29/2026
Facility Type Practitioner Other
Lab Director KEVIN GRANT, OD

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