36D2019115 CLIA NUMBER - PREMIER VISION GROUP

Laboratory Demographics

  • CLIA Code: 36D2019115
  • Facility Name: PREMIER VISION GROUP
  • Facility Address: 1222 RIDGEWOOD DRIVE
    BOWLING GREEN, OH
    ZIP 43402
  • Facility Phone: 419 352-2502
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MILE BRUJIC
  • NPI Number: 1245333715
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 36D2019115
LAB Type Physician Office
Facility Name PREMIER VISION GROUP
Street 1222 RIDGEWOOD DRIVE
City BOWLING GREEN
State OH
ZIP 43402
Phone 419 352-2502
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2025
Certificate Expiration Date 1/1/2027
Facility Type Physician Office
Lab Director MILE BRUJIC

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