52D0397986 CLIA NUMBER - THEDACARE MEDICAL CENTER - WAUPACA

Laboratory Demographics

CLIA Number: 52D0397986

Facility Name: THEDACARE MEDICAL CENTER - WAUPACA

Facility Address:
800 RIVERSIDE DR
WAUPACA, WI
ZIP 54981
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Facility Phone Number: 715 258-1207

Facility Type: Hospital

Certificate Type: Accreditation

NPI Number: 1760528798

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	52D0397986
LAB Type	Hospital
Facility Name	THEDACARE MEDICAL CENTER - WAUPACA
Street	800 RIVERSIDE DR
City	WAUPACA
State	WI
ZIP	54981
Phone	715 258-1207
CertificateType	1
CertificateEffectiveDate	1/3/2023
CertificateExpirationDate	1/2/2025
FacilityType	Accreditation

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