52D0392770 CLIA NUMBER - UW HEALTH-FORT ATKINSON

Laboratory Demographics

CLIA Number: 52D0392770

Facility Name: UW HEALTH-FORT ATKINSON

Facility Address:
1620 MEHTA LANE
FORT ATKINSON, WI
ZIP 53538
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Facility Phone Number: 920 563-5544

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1255392601

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	52D0392770
LAB Type	Physician Office
Facility Name	UW HEALTH-FORT ATKINSON
Street	1620 MEHTA LANE
City	FORT ATKINSON
State	WI
ZIP	53538
Phone	920 563-5544
CertificateType	2
CertificateEffectiveDate	6/3/2023
CertificateExpirationDate	6/2/2025
FacilityType	Compliance

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