52D0392760 CLIA NUMBER - SSM HEALTH DEAN MEDICAL GROUP - FORT ATKINSON

Laboratory Demographics

  • CLIA Code: 52D0392760
  • Facility Name: SSM HEALTH DEAN MEDICAL GROUP - FORT ATKINSON
  • Facility Address: 740 REENA AVE
    FORT ATKINSON, WI
    ZIP 53538
  • Facility Phone: 920 563-0888
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MS. JANIE M. CARROLL
  • NPI Number: 1144265133
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 52D0392760
LAB Type Physician Office
Facility Name SSM HEALTH DEAN MEDICAL GROUP - FORT ATKINSON
Street 740 REENA AVE
City FORT ATKINSON
State WI
ZIP 53538
Phone 920 563-0888
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/4/2024
Certificate Expiration Date 4/3/2026
Facility Type Physician Office
Lab Director MS. JANIE M. CARROLL

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