52D0662131 CLIA NUMBER - DOUGLAS COUNTY DEPT OF HEALTH & HS LABORATORY GOVERNMENT CENTER

Laboratory Demographics

  • CLIA Code: 52D0662131
  • Facility Name: DOUGLAS COUNTY DEPT OF HEALTH & HS LABORATORY GOVERNMENT CENTER
  • Facility Address: 1316 N 14TH ST SUITE 324
    SUPERIOR, WI
    ZIP 54880
  • Facility Phone: 715 395-1438
  • Facility Type: Public Health Laboratories
  • Facility Type: Waiver
  • Lab Director: MARK D. DRAKE, BA
  • NPI Number: 1992971980
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 52D0662131
LAB Type Public Health Laboratories
Facility Name DOUGLAS COUNTY DEPT OF HEALTH & HS LABORATORY GOVERNMENT CENTER
Street 1316 N 14TH ST SUITE 324
City SUPERIOR
State WI
ZIP 54880
Phone 715 395-1438
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2024
Certificate Expiration Date 10/12/2026
Facility Type Public Health Laboratories
Lab Director MARK D. DRAKE, BA

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