52D0669584 CLIA NUMBER - SHEBOYGAN SENIOR COMMUNITY, INC

Laboratory Demographics

  • CLIA Code: 52D0669584
  • Facility Name: SHEBOYGAN SENIOR COMMUNITY, INC
  • Facility Address: 3505 CTY RD Y
    SHEBOYGAN, WI
    ZIP 53083
  • Facility Phone: 920 458-2137
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MR. PAUL TREFFERT
  • NPI Number: 1609219195
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D0669584
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SHEBOYGAN SENIOR COMMUNITY, INC
Street 3505 CTY RD Y
City SHEBOYGAN
State WI
ZIP 53083
Phone 920 458-2137
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 Skilled Nursing Facility/Nursing Facility
Lab Director MR. PAUL TREFFERT

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