52D0674210 CLIA NUMBER - FOND DU LAC COUNTY HEALTH DEPARTMENT

Laboratory Demographics

  • CLIA Code: 52D0674210
  • Facility Name: FOND DU LAC COUNTY HEALTH DEPARTMENT
  • Facility Address: 160 S MACY ST
    FOND DU LAC, WI
    ZIP 54935
  • Facility Phone: (920) 929-3085
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MS. KIMBERLY M. MUELLER
  • NPI Number: 1679545917
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 52D0674210
LAB Type Home Health Agency
Facility Name FOND DU LAC COUNTY HEALTH DEPARTMENT
Street 160 S MACY ST
City FOND DU LAC
State WI
ZIP 54935
Phone 9209293085
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 MS. KIMBERLY M. MUELLER

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This page was last updated on: 5/18/2026