52D0396371 CLIA NUMBER - GUNDERSEN TRI COUNTY HOSPITAL AND CLINICS BLAIR CLINIC

Laboratory Demographics

  • CLIA Code: 52D0396371
  • Facility Name: GUNDERSEN TRI COUNTY HOSPITAL AND CLINICS BLAIR CLINIC
  • Facility Address: 420 S PETERSON AVE
    BLAIR, WI
    ZIP 54616
  • Facility Phone: 608 989-2505
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MS. DARCY J. GOPLIN
  • NPI Number: 1336190941
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D0396371
LAB Type Physician Office
Facility Name GUNDERSEN TRI COUNTY HOSPITAL AND CLINICS BLAIR CLINIC
Street 420 S PETERSON AVE
City BLAIR
State WI
ZIP 54616
Phone 608 989-2505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/29/2024
Certificate Expiration Date 2/27/2026
Facility Type Physician Office
Lab Director MS. DARCY J. GOPLIN

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