52D0039069 CLIA NUMBER - ROCKY KNOLL HEALTH CARE FACILITY

Laboratory Demographics

  • CLIA Code: 52D0039069
  • Facility Name: ROCKY KNOLL HEALTH CARE FACILITY
  • Facility Address: N7135 ROCKY KNOLL PARKWAY
    PLYMOUTH, WI
    ZIP 53073
  • Facility Phone: 920 893-6441
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MS. CLINTON KATHERINE
  • NPI Number: 1003988049
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D0039069
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ROCKY KNOLL HEALTH CARE FACILITY
Street N7135 ROCKY KNOLL PARKWAY
City PLYMOUTH
State WI
ZIP 53073
Phone 920 893-6441
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MS. CLINTON KATHERINE

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