52D0721134 CLIA NUMBER - GREEN BAY HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 52D0721134
  • Facility Name: GREEN BAY HEALTH SERVICES
  • Facility Address: 1640 SHAWANO AVE
    GREEN BAY, WI
    ZIP 54303
  • Facility Phone: 920 499-5177
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KRISTIN MOLSKI
  • NPI Number: 1265965974
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D0721134
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GREEN BAY HEALTH SERVICES
Street 1640 SHAWANO AVE
City GREEN BAY
State WI
ZIP 54303
Phone 920 499-5177
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 KRISTIN MOLSKI

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