52D0397177 CLIA NUMBER - TWIN PORTS HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 52D0397177
  • Facility Name: TWIN PORTS HEALTH SERVICES
  • Facility Address: 1612 N 37TH ST
    SUPERIOR, WI
    ZIP 54880
  • Facility Phone: 715 392-5144
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: VIANA JOHNSON
  • NPI Number: 1669914537
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D0397177
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name TWIN PORTS HEALTH SERVICES
Street 1612 N 37TH ST
City SUPERIOR
State WI
ZIP 54880
Phone 715 392-5144
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 VIANA JOHNSON

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