52D1020434 CLIA NUMBER - EMPLIFY HEALTH BEHAVIOR HEALTH

Laboratory Demographics

  • CLIA Code: 52D1020434
  • Facility Name: EMPLIFY HEALTH BEHAVIOR HEALTH
  • Facility Address: 301 E ST JOSEPH ST
    GREEN BAY, WI
    ZIP 54301
  • Facility Phone: 920 433-3630
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: MS. SHARLA D. BAENEN
  • NPI Number: 1669434288
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D1020434
LAB Type Ancillary Testing Site in Health Care Center
Facility Name EMPLIFY HEALTH BEHAVIOR HEALTH
Street 301 E ST JOSEPH ST
City GREEN BAY
State WI
ZIP 54301
Phone 920 433-3630
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Ancillary Testing Site in Health Care Center
Lab Director MS. SHARLA D. BAENEN

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