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52D0661948 CLIA NUMBER - MEDICAL COLLEGE OF WISCONSIN PEDIATRIC GASTROENTEROLOGY LABORATORY

Laboratory Demographics

CLIA Number: 52D0661948

Facility Name: MEDICAL COLLEGE OF WISCONSIN PEDIATRIC GASTROENTEROLOGY LABORATORY

Facility Address:
CRI ROOM C-3383 TBRC-CRI 3RD FLOOR 8701 WATERTOWN PLANK RD
MILWAUKEE, WI
ZIP 53226
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Facility Phone Number: 414 955-4166

Facility Type: Independent

Certificate Type: Certificate of Compliance
NPI Number: 1790092633

Taxonomy: 282N00000X - General Acute Care Hospital
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

CLIA Record

Field Name Field Value
CLIA Number 52D0661948
LAB Type Independent
Facility Name MEDICAL COLLEGE OF WISCONSIN PEDIATRIC GASTROENTEROLOGY LABORATORY
Street CRI ROOM C-3383 TBRC-CRI 3RD FLOOR 8701 WATERTOWN PLANK RD
City MILWAUKEE
State WI
ZIP 53226
Phone 414 955-4166
CertificateType 2
CertificateEffectiveDate 2/26/2023
CertificateExpirationDate 2/25/2025
FacilityType Compliance

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