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BONNER EYE CLINIC OPTICAL LLC
NPI 1093287849
Durable Medical Equipment & Medical Supplies in Grand Rapids, MN

Active since December 18, 2018CLIA 24D2076445 · Waiver
1542 GOLF COURSE RD STE 201, GRAND RAPIDS, MN 55744(218) 326-3433(218) 326-3435 Get Directions Write a Review

NPPES record last updated: December 18, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Bonner Eye Clinic Optical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BONNER EYE CLINIC OPTICAL LLC (NPI 1093287849) is a healthcare organization registered as a durable medical equipment & medical supplies in Grand Rapids, Minnesota and active in the NPI registry since December 2018. The organization holds a CLIA Waiver certificate valid through April 17, 2028, maintains a secondary practice location in Hibbing, and lists Manuel Jerry Mariano, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1093287849
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameBONNER EYE CLINIC OPTICAL LLC
Location Address1542 GOLF COURSE RD STE 201Grand Rapids, MN 55744-3537
Mailing Address1542 Golf Course Rd Ste 201Grand Rapids, MN 55744-3537 · (218) 326-3433 · Fax (218) 326-3435
Phone(218) 326-3433
Fax(218) 326-3435
Organization SubpartNo
Authorized OfficialManuel Jerry MarianoOwner/president · (218) 326-3433
Enumeration DateDecember 18, 2018
✔ NPI 1093287849 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
1542 GOLF COURSE RD STE 201, Grand Rapids, MN 55744
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Secondary Practice Location 1

Location 13605 Mayfair Ave Ste 2150Hibbing, MN 55746-2938 · Phone (218) 262-3156 · Fax (218) 326-3435

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2076445

Bonner Eye Clinic · Hibbing, MN
Active · expires Apr 17, 2028
CLIA Number24D2076445
Laboratory TypePhysician Office
Certificate Effective DateApril 18, 2026
Certificate Expiration DateApril 17, 2028
Laboratory DirectorMichaela Clwvwlnd
Laboratory Phone(218) 326-3433
Laboratory LocationBonner Eye Clinic3605 Mayfair Ave Suite 2150, Hibbing, MN 55746
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRANT ROBERT CARLISLE
Ophthalmology
1542 GOLF COURSE RD STE 201
GRAND RAPIDS, MN 55744
Itasca County (218) 326-3433
APRIL L BUESCHER APRN,CNP
Nurse Practitioner (Family)
1542 GOLF COURSE RD STE 201
GRAND RAPIDS, MN 55744
Itasca County (218) 322-4900
ABBY SPERR OD
Optometrist
1542 GOLF COURSE RD STE 201
GRAND RAPIDS, MN 55744
Itasca County (218) 326-3433
MR. MICHAEL C. YOUNG OD
Optometrist
1542 GOLF COURSE RD STE 201
GRAND RAPIDS, MN 55744
Itasca County (218) 326-3433

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bonner Eye Clinic Optical LLC's NPI number?

The NPI number for Bonner Eye Clinic Optical LLC is 1093287849. It was assigned to this organization in the NPPES registry on December 18, 2018.

Where is Bonner Eye Clinic Optical LLC located?

Bonner Eye Clinic Optical LLC is located at 1542 Golf Course Rd Ste 201, Grand Rapids, MN 55744. The listed phone number is (218) 326-3433.

What is Bonner Eye Clinic Optical LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Bonner Eye Clinic Optical LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2076445) is associated with this NPI, valid through April 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bonner Eye Clinic Optical LLC was last updated on December 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.