52D0678401 CLIA NUMBER - FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS

Laboratory Demographics

  • CLIA Code: 52D0678401
  • Facility Name: FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS
  • Facility Address: 1700 W PARADISE DR
    WEST BEND, WI
    ZIP 53095
  • Facility Phone: 262 677-7549
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. PATRICK M. GARDNER
  • NPI Number: 1124328232
  • Taxonomy: 225X00000X - Occupational Therapist

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CLIA Record

Field Name Field Value
CLIA Number 52D0678401
LAB Type Independent
Facility Name FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS
Street 1700 W PARADISE DR
City WEST BEND
State WI
ZIP 53095
Phone 262 677-7549
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/30/2024
Certificate Expiration Date 6/29/2026
Facility Type Independent
Lab Director DR. PATRICK M. GARDNER

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