52D0988777 CLIA NUMBER - FORT ATKINSON DIALYSIS

Laboratory Demographics

  • CLIA Code: 52D0988777
  • Facility Name: FORT ATKINSON DIALYSIS
  • Facility Address: 525 HANDEYSIDE LN STE A
    FORT ATKINSON, WI
    ZIP 53538
  • Facility Phone: 920 563-8665
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MR. LOGAN ELANGOVAN
  • NPI Number: 1245316892
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D0988777
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FORT ATKINSON DIALYSIS
Street 525 HANDEYSIDE LN STE A
City FORT ATKINSON
State WI
ZIP 53538
Phone 920 563-8665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2025
Certificate Expiration Date 7/8/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MR. LOGAN ELANGOVAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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