52D0681410 CLIA NUMBER - SOUTH MILWAUKEE HEALTH DEPARTMENT

Laboratory Demographics

CLIA Number: 52D0681410

Facility Name: SOUTH MILWAUKEE HEALTH DEPARTMENT

Facility Address:
2424 15TH AVENUE
SOUTH MILWAUKEE, WI
ZIP 53172
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Facility Phone Number: 414 764-5060

Facility Type: Public Health Laboratories

Certificate Type: Waiver

NPI Number: 1871795690

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	52D0681410
LAB Type	Public Health Laboratories
Facility Name	SOUTH MILWAUKEE HEALTH DEPARTMENT
Street	2424 15TH AVENUE
City	SOUTH MILWAUKEE
State	WI
ZIP	53172
Phone	414 764-5060
CertificateType	4
CertificateEffectiveDate	12/26/2023
CertificateExpirationDate	12/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024