52D1016891 CLIA NUMBER - LARSON HOUSE PLATINUM

Laboratory Demographics

  • CLIA Code: 52D1016891
  • Facility Name: LARSON HOUSE PLATINUM
  • Facility Address: 550 RIVER RD
    COLUMBUS, WI
    ZIP 53925
  • Facility Phone: 920 623-5253
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. MELISSA BLOOMHUFF
  • NPI Number: 1811517642
  • Taxonomy: 310400000X - Assisted Living Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D1016891
LAB Type Assisted Living Facility
Facility Name LARSON HOUSE PLATINUM
Street 550 RIVER RD
City COLUMBUS
State WI
ZIP 53925
Phone 920 623-5253
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2025
Certificate Expiration Date 1/20/2027
Facility Type Assisted Living Facility
Lab Director MS. MELISSA BLOOMHUFF

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