52D0724266 CLIA NUMBER - SSM HEALTH SUN PRAIRIE OUTPATIENT CENTER

Laboratory Demographics

  • CLIA Code: 52D0724266
  • Facility Name: SSM HEALTH SUN PRAIRIE OUTPATIENT CENTER
  • Facility Address: 2850 O'KEEFFE AVE
    SUN PRAIRIE, WI
    ZIP 53590
  • Facility Phone: 608 260-6166
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TAMARA AMUNDSEN
  • NPI Number: 1235201369
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D0724266
LAB Type Ambulatory Surgery Center
Facility Name SSM HEALTH SUN PRAIRIE OUTPATIENT CENTER
Street 2850 O'KEEFFE AVE
City SUN PRAIRIE
State WI
ZIP 53590
Phone 608 260-6166
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 Ambulatory Surgery Center
Lab Director TAMARA AMUNDSEN

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