52D0392619 CLIA NUMBER - NUTRITION & HEALTH ASSOCIATES

Laboratory Demographics

CLIA Number: 52D0392619

Facility Name: NUTRITION & HEALTH ASSOCIATES

Facility Address:
32 E RACINE ST
JANESVILLE, WI
ZIP 53545
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Facility Phone Number: 608 754-3722

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1265625651

Taxonomy: 251V00000X - Voluntary or Charitable

CLIA Record

Field Name	Field Value
CLIA Number	52D0392619
LAB Type	Community Clinic
Facility Name	NUTRITION & HEALTH ASSOCIATES
Street	32 E RACINE ST
City	JANESVILLE
State	WI
ZIP	53545
Phone	608 754-3722
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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