14D2078582 CLIA NUMBER - MARION EYE CENTERS LTD

Laboratory Demographics

  • CLIA Code: 14D2078582
  • Facility Name: MARION EYE CENTERS LTD
  • Facility Address: 2900 BROADWAY, STE A
    MOUNT VERNON, IL
    ZIP 62864
  • Facility Phone: 618 244-2777
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT L. KIPPENBROCK
  • NPI Number: 1346698602
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2078582
LAB Type Physician Office
Facility Name MARION EYE CENTERS LTD
Street 2900 BROADWAY, STE A
City MOUNT VERNON
State IL
ZIP 62864
Phone 618 244-2777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2024
Certificate Expiration Date 5/29/2026
Facility Type Physician Office
Lab Director ROBERT L. KIPPENBROCK

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