52D0397986 CLIA NUMBER - THEDACARE MEDICAL CENTER - WAUPACA

Laboratory Demographics

  • CLIA Code: 52D0397986
  • Facility Name: THEDACARE MEDICAL CENTER - WAUPACA
  • Facility Address: 800 RIVERSIDE DR
    WAUPACA, WI
    ZIP 54981
  • Facility Phone: 715 258-1207
  • Facility Type: Hospital
  • Facility Type: Accreditation
  • Lab Director: DR. ERIC DESTRAMPE
  • NPI Number: 1760528798
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 52D0397986
LAB Type Hospital
Facility Name THEDACARE MEDICAL CENTER - WAUPACA
Street 800 RIVERSIDE DR
City WAUPACA
State WI
ZIP 54981
Phone 715 258-1207
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 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Hospital
Lab Director DR. ERIC DESTRAMPE

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