52D0876214 CLIA NUMBER - INTERIM HEALTHCARE

Laboratory Demographics

  • CLIA Code: 52D0876214
  • Facility Name: INTERIM HEALTHCARE
  • Facility Address: 327 N 17TH AVE SUITE 7
    WAUSAU, WI
    ZIP 54401
  • Facility Phone: 715 842-7707
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: DEANNA GOLLUBSKE
  • NPI Number: 1518042597
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 52D0876214
LAB Type Home Health Agency
Facility Name INTERIM HEALTHCARE
Street 327 N 17TH AVE SUITE 7
City WAUSAU
State WI
ZIP 54401
Phone 715 842-7707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2025
Certificate Expiration Date 9/14/2027
Facility Type Home Health Agency
Lab Director DEANNA GOLLUBSKE

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