52D0721820 CLIA NUMBER - THEDACARE AT HOME

Laboratory Demographics

  • CLIA Code: 52D0721820
  • Facility Name: THEDACARE AT HOME
  • Facility Address: 3000 E COLLEGE AVE SUITE A
    APPLETON, WI
    ZIP 54915
  • Facility Phone: 920 969-0919
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MR. MICHAEL HUNTLEY
  • NPI Number: 1710155254
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 52D0721820
LAB Type Home Health Agency
Facility Name THEDACARE AT HOME
Street 3000 E COLLEGE AVE SUITE A
City APPLETON
State WI
ZIP 54915
Phone 920 969-0919
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 MR. MICHAEL HUNTLEY

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