14D2093409 CLIA NUMBER - FAIRBURY VISION CENTER LLC

Laboratory Demographics

  • CLIA Code: 14D2093409
  • Facility Name: FAIRBURY VISION CENTER LLC
  • Facility Address: 2 ASPEN COURT
    FAIRBURY, IL
    ZIP 61739
  • Facility Phone: (815) 692-2415
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SASHA L. RADFORD
  • NPI Number: 1144639105
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 14D2093409
LAB Type Physician Office
Facility Name FAIRBURY VISION CENTER LLC
Street 2 ASPEN COURT
City FAIRBURY
State IL
ZIP 61739
Phone 8156922415
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Physician Office
Lab Director SASHA L. RADFORD

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This page was last updated on: 5/18/2026