15D2178827 CLIA NUMBER - COLUMBIA CITY OPTOMETRY

Laboratory Demographics

  • CLIA Code: 15D2178827
  • Facility Name: COLUMBIA CITY OPTOMETRY
  • Facility Address: 512 N LINE STREET
    COLUMBIA CITY, IN
    ZIP 46725
  • Facility Phone: 260 244-6474
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ANGELA E. LEONARD
  • NPI Number: 1639359755
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 15D2178827
LAB Type Practitioner Other
Facility Name COLUMBIA CITY OPTOMETRY
Street 512 N LINE STREET
City COLUMBIA CITY
State IN
ZIP 46725
Phone 260 244-6474
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Practitioner Other
Lab Director ANGELA E. LEONARD

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