13D2123706 CLIA NUMBER - EAGLE VISION ONE

Laboratory Demographics

  • CLIA Code: 13D2123706
  • Facility Name: EAGLE VISION ONE
  • Facility Address: 355 S EAGLE RD
    EAGLE, ID
    ZIP 83616
  • Facility Phone: 208 938-2015
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AARON J. WARNER
  • NPI Number: 1699845503
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 13D2123706
LAB Type Physician Office
Facility Name EAGLE VISION ONE
Street 355 S EAGLE RD
City EAGLE
State ID
ZIP 83616
Phone 208 938-2015
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Physician Office
Lab Director AARON J. WARNER

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