23D2316138 CLIA NUMBER - MAIN STREET OPTOMETRY - DEXTER

Laboratory Demographics

  • CLIA Code: 23D2316138
  • Facility Name: MAIN STREET OPTOMETRY - DEXTER
  • Facility Address: 8089 MAIN STREET SUITE 1
    DEXTER, MI
    ZIP 48130
  • Facility Phone: 734 424-9230
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT R. BALTIERRA
  • NPI Number: 1083772008
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 23D2316138
LAB Type Physician Office
Facility Name MAIN STREET OPTOMETRY - DEXTER
Street 8089 MAIN STREET SUITE 1
City DEXTER
State MI
ZIP 48130
Phone 734 424-9230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2024
Certificate Expiration Date 12/29/2026
Facility Type Physician Office
Lab Director ROBERT R. BALTIERRA

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