14D1084737 CLIA NUMBER - VISION SALON EYE CARE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 14D1084737
  • Facility Name: VISION SALON EYE CARE ASSOCIATES
  • Facility Address: 12812 S WESTERN AVE
    BLUE ISLAND, IL
    ZIP 60406
  • Facility Phone: 708 385-0013
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANSEL T. JOHNSON
  • NPI Number: 1487727046
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 14D1084737
LAB Type Physician Office
Facility Name VISION SALON EYE CARE ASSOCIATES
Street 12812 S WESTERN AVE
City BLUE ISLAND
State IL
ZIP 60406
Phone 708 385-0013
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Physician Office
Lab Director ANSEL T. JOHNSON

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