52D0392556 CLIA NUMBER - UW-HEALTH - BELLEVILLE FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 52D0392556

Facility Name: UW-HEALTH - BELLEVILLE FAMILY MEDICINE

Facility Address:
1121 BELLWEST BLVD
BELLEVILLE, WI
ZIP 53508
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Facility Phone Number: 608 424-3384

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1154381028

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
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.

CLIA Record

Field Name	Field Value
CLIA Number	52D0392556
LAB Type	Physician Office
Facility Name	UW-HEALTH - BELLEVILLE FAMILY MEDICINE
Street	1121 BELLWEST BLVD
City	BELLEVILLE
State	WI
ZIP	53508
Phone	608 424-3384
CertificateType	2
CertificateEffectiveDate	7/6/2023
CertificateExpirationDate	7/5/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024