52D0394456 CLIA NUMBER - MENOMINEE TRIBAL CLINIC

Laboratory Demographics

  • CLIA Code: 52D0394456
  • Facility Name: MENOMINEE TRIBAL CLINIC
  • Facility Address: W3275 WOLF RIVER RD PO BOX 970
    KESHENA, WI
    ZIP 54135
  • Facility Phone: 715 799-3361
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Accreditation
  • Lab Director: DR. AMY J. SLAGLE
  • NPI Number: 1033785332
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 52D0394456
LAB Type Federally Qualified Health Center
Facility Name MENOMINEE TRIBAL CLINIC
Street W3275 WOLF RIVER RD PO BOX 970
City KESHENA
State WI
ZIP 54135
Phone 715 799-3361
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 1/13/2025
Certificate Expiration Date 1/12/2027
Facility Type Federally Qualified Health Center
Lab Director DR. AMY J. SLAGLE

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