52D0985608 CLIA NUMBER - TWIN LAKES FIRE DEPARTMENT AND RESCUE SQUAD INC

Laboratory Demographics

CLIA Number: 52D0985608

Facility Name: TWIN LAKES FIRE DEPARTMENT AND RESCUE SQUAD INC

Facility Address:
236 E MAIN ST
TWIN LAKES, WI
ZIP 53181
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Facility Phone Number: 262 877-2373

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1093821498

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	52D0985608
LAB Type	Ambulance
Facility Name	TWIN LAKES FIRE DEPARTMENT AND RESCUE SQUAD INC
Street	236 E MAIN ST
City	TWIN LAKES
State	WI
ZIP	53181
Phone	262 877-2373
CertificateType	4
CertificateEffectiveDate	4/24/2023
CertificateExpirationDate	4/23/2025
FacilityType	Waiver

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