14D2159817 CLIA NUMBER - LIFETIME EYE CARE

Laboratory Demographics

  • CLIA Code: 14D2159817
  • Facility Name: LIFETIME EYE CARE
  • Facility Address: 1700 18TH ST
    CHARLESTON, IL
    ZIP 61920
  • Facility Phone: 217 345-6600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK D. ESAREY
  • NPI Number: 1205424900
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 14D2159817
LAB Type Physician Office
Facility Name LIFETIME EYE CARE
Street 1700 18TH ST
City CHARLESTON
State IL
ZIP 61920
Phone 217 345-6600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2024
Certificate Expiration Date 12/26/2026
Facility Type Physician Office
Lab Director MARK D. ESAREY

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