52D0989196 CLIA NUMBER - NEWBURG FIRE DEPARTMENT AMBULANCE

Laboratory Demographics

  • CLIA Code: 52D0989196
  • Facility Name: NEWBURG FIRE DEPARTMENT AMBULANCE
  • Facility Address: 508 MAIN ST
    NEWBURG, WI
    ZIP 53060
  • Facility Phone: 262 675-6262
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MR. JEFF GONZALEZ
  • NPI Number: 1073616900
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 52D0989196
LAB Type Ambulance
Facility Name NEWBURG FIRE DEPARTMENT AMBULANCE
Street 508 MAIN ST
City NEWBURG
State WI
ZIP 53060
Phone 262 675-6262
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/19/2025
Certificate Expiration Date 7/18/2027
Facility Type Ambulance
Lab Director MR. JEFF GONZALEZ

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