52D0953792 CLIA NUMBER - PREVEA CLINIC - WEST DE PERE

Laboratory Demographics

  • CLIA Code: 52D0953792
  • Facility Name: PREVEA CLINIC - WEST DE PERE
  • Facility Address: 1686 EISENHOWER RD
    DE PERE, WI
    ZIP 54115
  • Facility Phone: 920 496-4700
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. DAVID SPIKA
  • NPI Number: 1396874582
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 52D0953792
LAB Type Physician Office
Facility Name PREVEA CLINIC - WEST DE PERE
Street 1686 EISENHOWER RD
City DE PERE
State WI
ZIP 54115
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 2/23/2025
Certificate Expiration Date 2/22/2027
Facility Type Physician Office
Lab Director DR. DAVID SPIKA

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