23D2125383 CLIA NUMBER - MONROE VISION SOURCE

Laboratory Demographics

  • CLIA Code: 23D2125383
  • Facility Name: MONROE VISION SOURCE
  • Facility Address: 750 STEWARD ROAD SUITE 2
    MONROE, MI
    ZIP 48162
  • Facility Phone: 734 242-8630
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES D. HARDIE
  • NPI Number: 1174920748
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2125383
LAB Type Physician Office
Facility Name MONROE VISION SOURCE
Street 750 STEWARD ROAD SUITE 2
City MONROE
State MI
ZIP 48162
Phone 734 242-8630
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2025
Certificate Expiration Date 2/6/2027
Facility Type Physician Office
Lab Director JAMES D. HARDIE

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