52D0895605 CLIA NUMBER - SSM HEALTH DEAN MEDICAL GROUP - EDGERTON

Laboratory Demographics

  • CLIA Code: 52D0895605
  • Facility Name: SSM HEALTH DEAN MEDICAL GROUP - EDGERTON
  • Facility Address: 11051 N SHERMAN RD
    EDGERTON, WI
    ZIP 53534
  • Facility Phone: 608 258-6169
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OLIVIA BRITTAN
  • NPI Number: 1073558045
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 52D0895605
LAB Type Physician Office
Facility Name SSM HEALTH DEAN MEDICAL GROUP - EDGERTON
Street 11051 N SHERMAN RD
City EDGERTON
State WI
ZIP 53534
Phone 608 258-6169
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2025
Certificate Expiration Date 2/6/2027
Facility Type Physician Office
Lab Director OLIVIA BRITTAN

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