52D0910424 CLIA NUMBER - CEDARBURG FIRE DEPT/RESCUE SQUAD

Laboratory Demographics

  • CLIA Code: 52D0910424
  • Facility Name: CEDARBURG FIRE DEPT/RESCUE SQUAD
  • Facility Address: W61 N631 MEQUON AVE PO BOX 327
    CEDARBURG, WI
    ZIP 53012
  • Facility Phone: 262 375-7630
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: KIM M. GORDON
  • NPI Number: 1134176787
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 52D0910424
LAB Type Ambulance
Facility Name CEDARBURG FIRE DEPT/RESCUE SQUAD
Street W61 N631 MEQUON AVE PO BOX 327
City CEDARBURG
State WI
ZIP 53012
Phone 262 375-7630
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2024
Certificate Expiration Date 1/7/2026
Facility Type Ambulance
Lab Director KIM M. GORDON

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