52D0986047 CLIA NUMBER - BLOOMFIELD GENOA CITY FIRE & RESCUE

Laboratory Demographics

  • CLIA Code: 52D0986047
  • Facility Name: BLOOMFIELD GENOA CITY FIRE & RESCUE
  • Facility Address: N1113 CLOVER RD
    PELL LAKE, WI
    ZIP 53157
  • Facility Phone: 262 279-2033
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MR. FREDRIC J. SCHALOW
  • NPI Number: 1558444828
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 52D0986047
LAB Type Ambulance
Facility Name BLOOMFIELD GENOA CITY FIRE & RESCUE
Street N1113 CLOVER RD
City PELL LAKE
State WI
ZIP 53157
Phone 262 279-2033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2025
Certificate Expiration Date 5/6/2027
Facility Type Ambulance
Lab Director MR. FREDRIC J. SCHALOW

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