14D2076796 CLIA NUMBER - PRAIRIE EYE CENTER

Laboratory Demographics

  • CLIA Code: 14D2076796
  • Facility Name: PRAIRIE EYE CENTER
  • Facility Address: 2000 W MORTON AVE
    JACKSONVILLE, IL
    ZIP 62650
  • Facility Phone: 217 245-6814
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANDRA YEH M D
  • NPI Number: 1578766515
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 14D2076796
LAB Type Physician Office
Facility Name PRAIRIE EYE CENTER
Street 2000 W MORTON AVE
City JACKSONVILLE
State IL
ZIP 62650
Phone 217 245-6814
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Physician Office
Lab Director SANDRA YEH M D

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