52D2062793 CLIA NUMBER - CHIPPEWA VALLEY EYE CLINIC, LLC

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Laboratory Demographics

CLIA Number: 52D2062793

Facility Name: CHIPPEWA VALLEY EYE CLINIC, LLC

Facility Address:
2715 DAMON ST
EAU CLAIRE, WI
ZIP 54701
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Facility Phone Number: 715 834-8471

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1407858939

Taxonomy: 332H00000X - Eyewear Supplier
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

CLIA Record

Field Name	Field Value
CLIA Number	52D2062793
LAB Type	Physician Office
Facility Name	CHIPPEWA VALLEY EYE CLINIC, LLC
Street	2715 DAMON ST
City	EAU CLAIRE
State	WI
ZIP	54701
Phone	715 834-8471
CertificateType	4
CertificateEffectiveDate	7/23/2023
CertificateExpirationDate	7/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024