52D0882487 CLIA NUMBER - BETHANY HOME, INC

Laboratory Demographics

  • CLIA Code: 52D0882487
  • Facility Name: BETHANY HOME, INC
  • Facility Address: 1226 BERLIN STREET ATTN SHANNON SCHUELKE
    WAUPACA, WI
    ZIP 54981
  • Facility Phone: 715 942-1469
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. ELLEN WENBERG
  • NPI Number: 1215934963
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D0882487
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BETHANY HOME, INC
Street 1226 BERLIN STREET ATTN SHANNON SCHUELKE
City WAUPACA
State WI
ZIP 54981
Phone 715 942-1469
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. ELLEN WENBERG

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