14D2192105 CLIA NUMBER - GUSTAFSON EYE CARE

Laboratory Demographics

  • CLIA Code: 14D2192105
  • Facility Name: GUSTAFSON EYE CARE
  • Facility Address: 96 W NORTHWEST HWY
    PALATINE, IL
    ZIP 60067
  • Facility Phone: 847 358-7722
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KELLY D. OLIVER
  • NPI Number: 1215138771
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 14D2192105
LAB Type Physician Office
Facility Name GUSTAFSON EYE CARE
Street 96 W NORTHWEST HWY
City PALATINE
State IL
ZIP 60067
Phone 847 358-7722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/4/2024
Certificate Expiration Date 9/3/2026
Facility Type Physician Office
Lab Director KELLY D. OLIVER

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