52D0392762 CLIA NUMBER - BEDROCK HCS AT ATKINSON LLC

Laboratory Demographics

  • CLIA Code: 52D0392762
  • Facility Name: BEDROCK HCS AT ATKINSON LLC
  • Facility Address: 430 WILCOX ST
    FORT ATKINSON, WI
    ZIP 53538
  • Facility Phone: 920 563-5533
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MS. ASHLEY VIRGO
  • NPI Number: 1760033898
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D0392762
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BEDROCK HCS AT ATKINSON LLC
Street 430 WILCOX ST
City FORT ATKINSON
State WI
ZIP 53538
Phone 920 563-5533
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MS. ASHLEY VIRGO

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