52D0695003 CLIA NUMBER - PEABODY MANOR INC

Laboratory Demographics

  • CLIA Code: 52D0695003
  • Facility Name: PEABODY MANOR INC
  • Facility Address: 2600 S HERITAGE WOODS DR
    APPLETON, WI
    ZIP 54915
  • Facility Phone: 920 738-3000
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MS. CYNTHIA R. GRINDHEIM
  • NPI Number: 1326079757
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D0695003
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PEABODY MANOR INC
Street 2600 S HERITAGE WOODS DR
City APPLETON
State WI
ZIP 54915
Phone 920 738-3000
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 MS. CYNTHIA R. GRINDHEIM

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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