52D0879528 CLIA NUMBER - ASPIRUS DIVINE SAVIOR CLINICS

Laboratory Demographics

  • CLIA Code: 52D0879528
  • Facility Name: ASPIRUS DIVINE SAVIOR CLINICS
  • Facility Address: 2817 NEW PINERY RD
    PORTAGE, WI
    ZIP 53901
  • Facility Phone: (608) 745-5030
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: DR. PAMELA PINEDA GOODELL

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CLIA Record

Field Name Field Value
CLIA Number 52D0879528
LAB Type Rural Health Clinic
Facility Name ASPIRUS DIVINE SAVIOR CLINICS
Street 2817 NEW PINERY RD
City PORTAGE
State WI
ZIP 53901
Phone 6087455030
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/1/2026
Certificate Expiration Date 12/31/2027
Facility Type Rural Health Clinic
Lab Director DR. PAMELA PINEDA GOODELL

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This page was last updated on: 6/29/2026