52D2315446 CLIA NUMBER - GRIEBENOW EYECARE

Laboratory Demographics

  • CLIA Code: 52D2315446
  • Facility Name: GRIEBENOW EYECARE
  • Facility Address: 105 NORTHRIDGE DR
    NEW LONDON, WI
    ZIP 54961
  • Facility Phone: 920 982-3711
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CHRISTOPHER LOPEZ
  • NPI Number: 1003045402
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 52D2315446
LAB Type Physician Office
Facility Name GRIEBENOW EYECARE
Street 105 NORTHRIDGE DR
City NEW LONDON
State WI
ZIP 54961
Phone 920 982-3711
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Physician Office
Lab Director DR. CHRISTOPHER LOPEZ

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