52D0389923 CLIA NUMBER - FAIRHAVEN CORPORATION

Laboratory Demographics

  • CLIA Code: 52D0389923
  • Facility Name: FAIRHAVEN CORPORATION
  • Facility Address: 435 W STARIN RD
    WHITEWATER, WI
    ZIP 53190
  • Facility Phone: 262 473-2140
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JESSICA WARD
  • NPI Number: 1083619761
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D0389923
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FAIRHAVEN CORPORATION
Street 435 W STARIN RD
City WHITEWATER
State WI
ZIP 53190
Phone 262 473-2140
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 JESSICA WARD

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This page was last updated on: 3/20/2025