52D0941616 CLIA NUMBER - PROHEALTH MEDICAL GROUP, INC - WAUKESHA BIG BEND ROAD

Laboratory Demographics

  • CLIA Code: 52D0941616
  • Facility Name: PROHEALTH MEDICAL GROUP, INC - WAUKESHA BIG BEND ROAD
  • Facility Address: 2130 BIG BEND RD
    WAUKESHA, WI
    ZIP 53189
  • Facility Phone: 262 513-7555
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. STEVEN W. KLEMISH
  • NPI Number: 1225666399
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 52D0941616
LAB Type Physician Office
Facility Name PROHEALTH MEDICAL GROUP, INC - WAUKESHA BIG BEND ROAD
Street 2130 BIG BEND RD
City WAUKESHA
State WI
ZIP 53189
Phone 262 513-7555
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/27/2024
Certificate Expiration Date 2/26/2026
Facility Type Physician Office
Lab Director DR. STEVEN W. KLEMISH

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This page was last updated on: 6/4/2025