52D0982094 CLIA NUMBER - CHILDREN'S HOSPITAL OF WI-FOX VALLEY THEDA CLARK MEDICAL CENTER CAMPUS

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Laboratory Demographics

CLIA Number: 52D0982094

Facility Name: CHILDREN'S HOSPITAL OF WI-FOX VALLEY THEDA CLARK MEDICAL CENTER CAMPUS

Facility Address:
130 2ND ST
NEENAH, WI
ZIP 54956
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Facility Phone Number: 920 969-7902

Facility Type: Hospital

Certificate Type: Accreditation

NPI Number: 1962676734

Taxonomy: 101YM0800X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	52D0982094
LAB Type	Hospital
Facility Name	CHILDREN'S HOSPITAL OF WI-FOX VALLEY THEDA CLARK MEDICAL CENTER CAMPUS
Street	130 2ND ST
City	NEENAH
State	WI
ZIP	54956
Phone	920 969-7902
CertificateType	1
CertificateEffectiveDate	2/5/2023
CertificateExpirationDate	2/4/2025
FacilityType	Accreditation

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