52D0931185 CLIA NUMBER - QUAD MED CLINIC-LOMIRA

Laboratory Demographics

  • CLIA Code: 52D0931185
  • Facility Name: QUAD MED CLINIC-LOMIRA
  • Facility Address: N11869 HWY 175
    LOMIRA, WI
    ZIP 53048
  • Facility Phone: 920 269-5003
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. COURTNEY YOUNG
  • NPI Number: 1801908306
  • Taxonomy: 3336C0002X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D0931185
LAB Type Physician Office
Facility Name QUAD MED CLINIC-LOMIRA
Street N11869 HWY 175
City LOMIRA
State WI
ZIP 53048
Phone 920 269-5003
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2023
Certificate Expiration Date 12/21/2025
Facility Type Physician Office
Lab Director DR. COURTNEY YOUNG

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