52D0389929 CLIA NUMBER - SSM HEALTH DEAN MEDICAL GROUP - WHITEWATER

Laboratory Demographics

  • CLIA Code: 52D0389929
  • Facility Name: SSM HEALTH DEAN MEDICAL GROUP - WHITEWATER
  • Facility Address: 1305 MAIN ST
    WHITEWATER, WI
    ZIP 53190
  • Facility Phone: 262 473-4548
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MS. AMY M. LECLAIR
  • NPI Number: 1962447953
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 52D0389929
LAB Type Physician Office
Facility Name SSM HEALTH DEAN MEDICAL GROUP - WHITEWATER
Street 1305 MAIN ST
City WHITEWATER
State WI
ZIP 53190
Phone 262 473-4548
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Physician Office
Lab Director MS. AMY M. LECLAIR

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