52D0921590 CLIA NUMBER - WOMEN'S CARE OF WISCONSIN

Laboratory Demographics

CLIA Number: 52D0921590

Facility Name: WOMEN'S CARE OF WISCONSIN

Facility Address:
5485 GRANDE MARKET DR SUITE C
APPLETON, WI
ZIP 54913
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Facility Phone Number: 920 729-7105

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1003811993

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	52D0921590
LAB Type	Physician Office
Facility Name	WOMEN'S CARE OF WISCONSIN
Street	5485 GRANDE MARKET DR SUITE C
City	APPLETON
State	WI
ZIP	54913
Phone	920 729-7105
CertificateType	2
CertificateEffectiveDate	4/8/2024
CertificateExpirationDate	4/7/2026
FacilityType	Compliance

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This page was last updated on: 4/23/2024