36D2140048 CLIA NUMBER - GRAND LAKE EYECARE, LLC

Laboratory Demographics

  • CLIA Code: 36D2140048
  • Facility Name: GRAND LAKE EYECARE, LLC
  • Facility Address: 2024 HOLIDAY DR
    CELINA, OH
    ZIP 45822
  • Facility Phone: 419 586-3151
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN T. GERLACH
  • NPI Number: 1184896383
  • Taxonomy: 213ES0103X - Podiatrist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 36D2140048
LAB Type Physician Office
Facility Name GRAND LAKE EYECARE, LLC
Street 2024 HOLIDAY DR
City CELINA
State OH
ZIP 45822
Phone 419 586-3151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Physician Office
Lab Director BRIAN T. GERLACH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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