14D2096392 CLIA NUMBER - VINTAGE OPTICAL - DR BRIAN SOMMER

Laboratory Demographics

  • CLIA Code: 14D2096392
  • Facility Name: VINTAGE OPTICAL - DR BRIAN SOMMER
  • Facility Address: 605 S MAIN ST
    MORTON, IL
    ZIP 61550
  • Facility Phone: 309 263-8611
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN C. SOMMER
  • NPI Number: 1073756490
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 14D2096392
LAB Type Physician Office
Facility Name VINTAGE OPTICAL - DR BRIAN SOMMER
Street 605 S MAIN ST
City MORTON
State IL
ZIP 61550
Phone 309 263-8611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2025
Certificate Expiration Date 5/21/2027
Facility Type Physician Office
Lab Director BRIAN C. SOMMER

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