52D0394034 CLIA NUMBER - BEDROCK HCS AT BEAVER DAM LLC

Laboratory Demographics

  • CLIA Code: 52D0394034
  • Facility Name: BEDROCK HCS AT BEAVER DAM LLC
  • Facility Address: 410 ROEDL COURT
    BEAVER DAM, WI
    ZIP 53916
  • Facility Phone: 920 887-7191
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MS. EMILY STREEKSTRA
  • NPI Number: 1679124705
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D0394034
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BEDROCK HCS AT BEAVER DAM LLC
Street 410 ROEDL COURT
City BEAVER DAM
State WI
ZIP 53916
Phone 920 887-7191
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. EMILY STREEKSTRA

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