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52D0394122 CLIA NUMBER - NEW LISBON FAMILY MEDICAL CENTER

Laboratory Demographics

CLIA Number: 52D0394122

Facility Name: NEW LISBON FAMILY MEDICAL CENTER

Facility Address:
901 W BRIDGE ST
NEW LISBON, WI
ZIP 53950
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Facility Phone Number: 608 562-3111

Facility Type: Rural Health Clinic

Certificate Type: Accreditation
NPI Number: 1174717656

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 52D0394122
LAB Type Rural Health Clinic
Facility Name NEW LISBON FAMILY MEDICAL CENTER
Street 901 W BRIDGE ST
City NEW LISBON
State WI
ZIP 53950
Phone 608 562-3111
CertificateType 1
CertificateEffectiveDate 12/10/2023
CertificateExpirationDate 12/9/2025
FacilityType Accreditation

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