Healther Providers Data Logo

52D0397908 CLIA NUMBER - ASCENSION MEDICAL GROUP- FOX VALLEY WISCONSIN INC D/B/A ASCENSION MEDICAL GROUP

Laboratory Demographics

CLIA Number: 52D0397908

Facility Name: ASCENSION MEDICAL GROUP- FOX VALLEY WISCONSIN INC D/B/A ASCENSION MEDICAL GROUP

Facility Address:
1420 ALGOMA ST
NEW LONDON, WI
ZIP 54961
Get Directions

Facility Phone Number: 920 982-8341

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1639282544

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name Field Value
CLIA Number 52D0397908
LAB Type Physician Office
Facility Name ASCENSION MEDICAL GROUP- FOX VALLEY WISCONSIN INC D/B/A ASCENSION MEDICAL GROUP
Street 1420 ALGOMA ST
City NEW LONDON
State WI
ZIP 54961
Phone 920 982-8341
CertificateType 3
CertificateEffectiveDate 10/1/2022
CertificateExpirationDate 9/30/2024
FacilityType PPMP

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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