15D2134279 CLIA NUMBER - MIDWEST EYE CONSULTANTS - MARION 02

Laboratory Demographics

  • CLIA Code: 15D2134279
  • Facility Name: MIDWEST EYE CONSULTANTS - MARION 02
  • Facility Address: 1400 N BALDWIN
    MARION, IN
    ZIP 46952
  • Facility Phone: 765 664-6148
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DANIEL D. DIEDRICH
  • NPI Number: 1225099674
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 15D2134279
LAB Type Practitioner Other
Facility Name MIDWEST EYE CONSULTANTS - MARION 02
Street 1400 N BALDWIN
City MARION
State IN
ZIP 46952
Phone 765 664-6148
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2025
Certificate Expiration Date 7/30/2027
Facility Type Practitioner Other
Lab Director DANIEL D. DIEDRICH

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