52D0669954 CLIA NUMBER - COLUMBIA COUNTY DIVISION OF HEALTH

Laboratory Demographics

  • CLIA Code: 52D0669954
  • Facility Name: COLUMBIA COUNTY DIVISION OF HEALTH
  • Facility Address: 111 E MULLETT ST PO BOX 136
    PORTAGE, WI
    ZIP 53901
  • Facility Phone: 608 742-9227
  • Facility Type: Public Health Laboratories
  • Facility Type: Waiver
  • Lab Director: ELLEN ELLINGSWORTH
  • NPI Number: 1679748057
  • Taxonomy: 261QR0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D0669954
LAB Type Public Health Laboratories
Facility Name COLUMBIA COUNTY DIVISION OF HEALTH
Street 111 E MULLETT ST PO BOX 136
City PORTAGE
State WI
ZIP 53901
Phone 608 742-9227
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 Public Health Laboratories
Lab Director ELLEN ELLINGSWORTH

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