15D2147595 CLIA NUMBER - MIDWEST EYE CONSULTANTS #48

Laboratory Demographics

  • CLIA Code: 15D2147595
  • Facility Name: MIDWEST EYE CONSULTANTS #48
  • Facility Address: 13197 ST RD 23
    GRANGER, IN
    ZIP 46530
  • Facility Phone: 574 247-1500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CAILEY WILLHARDT
  • NPI Number: 1861882797
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 15D2147595
LAB Type Physician Office
Facility Name MIDWEST EYE CONSULTANTS #48
Street 13197 ST RD 23
City GRANGER
State IN
ZIP 46530
Phone 574 247-1500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2024
Certificate Expiration Date 4/22/2026
Facility Type Physician Office
Lab Director CAILEY WILLHARDT

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