52D0662089 CLIA NUMBER - JACKSON COUNTY PUBLIC HEALTH DEPT

Laboratory Demographics

  • CLIA Code: 52D0662089
  • Facility Name: JACKSON COUNTY PUBLIC HEALTH DEPT
  • Facility Address: 421 COUNTY ROAD R
    BLACK RIVER FALLS, WI
    ZIP 54615
  • Facility Phone: 715 284-4301
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: CHRISTINE M. HOVELL, RN
  • NPI Number: 1558738872
  • Taxonomy: 252Y00000X - Early Intervention Provider Agency

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CLIA Record

Field Name Field Value
CLIA Number 52D0662089
LAB Type Home Health Agency
Facility Name JACKSON COUNTY PUBLIC HEALTH DEPT
Street 421 COUNTY ROAD R
City BLACK RIVER FALLS
State WI
ZIP 54615
Phone 715 284-4301
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 Home Health Agency
Lab Director CHRISTINE M. HOVELL, RN

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