52D0987626 CLIA NUMBER - LAKE AREA FREE CLINIC

Laboratory Demographics

  • CLIA Code: 52D0987626
  • Facility Name: LAKE AREA FREE CLINIC
  • Facility Address: 856 ARMOUR RD STE B
    OCONOMOWOC, WI
    ZIP 53066
  • Facility Phone: 262 569-4990
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: CRYSTAL CEPICAN
  • NPI Number: 1508391079
  • Taxonomy: 251V00000X - Voluntary or Charitable

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CLIA Record

Field Name Field Value
CLIA Number 52D0987626
LAB Type Community Clinic
Facility Name LAKE AREA FREE CLINIC
Street 856 ARMOUR RD STE B
City OCONOMOWOC
State WI
ZIP 53066
Phone 262 569-4990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2025
Certificate Expiration Date 6/7/2027
Facility Type Community Clinic
Lab Director CRYSTAL CEPICAN

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