15D2257558 CLIA NUMBER - GAILMARD EYE CENTER, LLC

Laboratory Demographics

  • CLIA Code: 15D2257558
  • Facility Name: GAILMARD EYE CENTER, LLC
  • Facility Address: 630 RIDGE ROAD MUNSTER
    MUNSTER, IN
    ZIP 46321
  • Facility Phone: 219 836-1738
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUZANNA ACOSTA
  • NPI Number: 1982746293
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 15D2257558
LAB Type Physician Office
Facility Name GAILMARD EYE CENTER, LLC
Street 630 RIDGE ROAD MUNSTER
City MUNSTER
State IN
ZIP 46321
Phone 219 836-1738
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Physician Office
Lab Director SUZANNA ACOSTA

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This page was last updated on: 6/4/2025