52D0882881 CLIA NUMBER - EVANSVILLE MANOR

Laboratory Demographics

  • CLIA Code: 52D0882881
  • Facility Name: EVANSVILLE MANOR
  • Facility Address: 470 GARFIELD AVE
    EVANSVILLE, WI
    ZIP 53536
  • Facility Phone: (608) 882-5700
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JOCELYN GLASS
  • NPI Number: 1205311917
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D0882881
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EVANSVILLE MANOR
Street 470 GARFIELD AVE
City EVANSVILLE
State WI
ZIP 53536
Phone 6088825700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2026
Certificate Expiration Date 2/18/2028
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JOCELYN GLASS

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This page was last updated on: 5/18/2026