52D0988969 CLIA NUMBER - CADOTT COMMUNITY AMBULANCE

Laboratory Demographics

CLIA Number: 52D0988969

Facility Name: CADOTT COMMUNITY AMBULANCE

Facility Address:
110 CENTRAL ST
CADOTT, WI
ZIP 54727
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Facility Phone Number: 715 723-3416

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1205881760

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	52D0988969
LAB Type	Ambulance
Facility Name	CADOTT COMMUNITY AMBULANCE
Street	110 CENTRAL ST
City	CADOTT
State	WI
ZIP	54727
Phone	715 723-3416
CertificateType	4
CertificateEffectiveDate	7/12/2023
CertificateExpirationDate	7/11/2025
FacilityType	Waiver

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