52D0984282 CLIA NUMBER - CORNERSTONE FOUNDATION

Laboratory Demographics

CLIA Number: 52D0984282

Facility Name: CORNERSTONE FOUNDATION

Facility Address:
201 N KENZIE ST
BARNEVELD, WI
ZIP 53507
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Facility Phone Number: 608 935-1649

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1699062182

Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	52D0984282
LAB Type	Other
Facility Name	CORNERSTONE FOUNDATION
Street	201 N KENZIE ST
City	BARNEVELD
State	WI
ZIP	53507
Phone	608 935-1649
CertificateType	4
CertificateEffectiveDate	3/19/2023
CertificateExpirationDate	3/18/2025
FacilityType	Waiver

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