52D2049256 CLIA NUMBER - COMMUNITY EYECARE INC

Laboratory Demographics

  • CLIA Code: 52D2049256
  • Facility Name: COMMUNITY EYECARE INC
  • Facility Address: 950 W RYAN ST
    BRILLION, WI
    ZIP 54110
  • Facility Phone: 920 756-2020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CHARLES J. BURGESS
  • NPI Number: 1548457757
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 52D2049256
LAB Type Physician Office
Facility Name COMMUNITY EYECARE INC
Street 950 W RYAN ST
City BRILLION
State WI
ZIP 54110
Phone 920 756-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Physician Office
Lab Director DR. CHARLES J. BURGESS

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