14D2110947 CLIA NUMBER - MARION EYE CENTER LTD - SPARTA

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CLIA Record

Field Name Field Value
CLIA Number 14D2110947
LAB Type Physician Office
Facility Name MARION EYE CENTER LTD - SPARTA
Street 216 NORTH MARKET
City SPARTA
State IL
ZIP 62286
Phone 618 443-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Physician Office
Lab Director ROBERT KIPPENBROCK OD

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