52D1016893 CLIA NUMBER - BROOKDALE APPLETON

Laboratory Demographics

  • CLIA Code: 52D1016893
  • Facility Name: BROOKDALE APPLETON
  • Facility Address: 5800 PENNSYLVANIA AVE
    APPLETON, WI
    ZIP 54914
  • Facility Phone: 920 997-0725
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. CHRISTINE GREGORIUS
  • NPI Number: 1275817306
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D1016893
LAB Type Assisted Living Facility
Facility Name BROOKDALE APPLETON
Street 5800 PENNSYLVANIA AVE
City APPLETON
State WI
ZIP 54914
Phone 920 997-0725
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Assisted Living Facility
Lab Director MS. CHRISTINE GREGORIUS

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