52D0929779 CLIA NUMBER - PARTNERSHIP COMMUNITY HEALTH CENTER

Laboratory Demographics

CLIA Number: 52D0929779

Facility Name: PARTNERSHIP COMMUNITY HEALTH CENTER

Facility Address:
5471 WATERFORD LANE
APPLETON, WI
ZIP 54913
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Facility Phone Number: 920 731-7445

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1225074008

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	52D0929779
LAB Type	Federally Qualified Health Center
Facility Name	PARTNERSHIP COMMUNITY HEALTH CENTER
Street	5471 WATERFORD LANE
City	APPLETON
State	WI
ZIP	54913
Phone	920 731-7445
CertificateType	4
CertificateEffectiveDate	10/15/2022
CertificateExpirationDate	10/14/2024
FacilityType	Waiver

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