52D0391416 CLIA NUMBER - CHARLES J WAISBREN MD

Laboratory Demographics

  • CLIA Code: 52D0391416
  • Facility Name: CHARLES J WAISBREN MD
  • Facility Address: 201 N MAYFAIR RD, SUITE 510
    WAUWATOSA, WI
    ZIP 53226
  • Facility Phone: 414 771-5900
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. CHARLES WAISBREN
  • NPI Number: 1952620809
  • Taxonomy: 2080P0203X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 52D0391416
LAB Type Physician Office
Facility Name CHARLES J WAISBREN MD
Street 201 N MAYFAIR RD, SUITE 510
City WAUWATOSA
State WI
ZIP 53226
Phone 414 771-5900
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Physician Office
Lab Director DR. CHARLES WAISBREN

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