13D2041621 CLIA NUMBER - ADVANCED EYECARE

Laboratory Demographics

  • CLIA Code: 13D2041621
  • Facility Name: ADVANCED EYECARE
  • Facility Address: 901 12TH AVE S
    NAMPA, ID
    ZIP 83651
  • Facility Phone: 208 466-9251
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL L. TILLER
  • NPI Number: 1861485989
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 13D2041621
LAB Type Physician Office
Facility Name ADVANCED EYECARE
Street 901 12TH AVE S
City NAMPA
State ID
ZIP 83651
Phone 208 466-9251
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2024
Certificate Expiration Date 5/24/2026
Facility Type Physician Office
Lab Director DANIEL L. TILLER

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