52D0931264 CLIA NUMBER - MISHICOT AREA AMBULANCE SERVICE

Laboratory Demographics

  • CLIA Code: 52D0931264
  • Facility Name: MISHICOT AREA AMBULANCE SERVICE
  • Facility Address: 511 EAST MAIN ST
    MISHICOT, WI
    ZIP 54228
  • Facility Phone: 920 629-2252
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MR. THERESA A. BECKER
  • NPI Number: 1134347750
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 52D0931264
LAB Type Ambulance
Facility Name MISHICOT AREA AMBULANCE SERVICE
Street 511 EAST MAIN ST
City MISHICOT
State WI
ZIP 54228
Phone 920 629-2252
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2025
Certificate Expiration Date 7/24/2027
Facility Type Ambulance
Lab Director MR. THERESA A. BECKER

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