52D0921997 CLIA NUMBER - PREVEA CLINIC-EAST MASON

Laboratory Demographics

  • CLIA Code: 52D0921997
  • Facility Name: PREVEA CLINIC-EAST MASON
  • Facility Address: 3021 VOYAGER DR
    GREEN BAY, WI
    ZIP 54311
  • Facility Phone: 920 496-4700
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. CHARLES F. DAIS II
  • NPI Number: 1417300518
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D0921997
LAB Type Physician Office
Facility Name PREVEA CLINIC-EAST MASON
Street 3021 VOYAGER DR
City GREEN BAY
State WI
ZIP 54311
Phone 920 496-4700
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 7/12/2025
Certificate Expiration Date 7/11/2027
Facility Type Physician Office
Lab Director DR. CHARLES F. DAIS II

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