52D1024780 CLIA NUMBER - PEDIATRICS WEST/LORELLE M MANION MD SC

Laboratory Demographics

  • CLIA Code: 52D1024780
  • Facility Name: PEDIATRICS WEST/LORELLE M MANION MD SC
  • Facility Address: 1305 N BARKER RD, STE 1
    BROOKFIELD, WI
    ZIP 53045
  • Facility Phone: 262 784-3200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. LORELLE M. MANION
  • NPI Number: 1831343797
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 52D1024780
LAB Type Physician Office
Facility Name PEDIATRICS WEST/LORELLE M MANION MD SC
Street 1305 N BARKER RD, STE 1
City BROOKFIELD
State WI
ZIP 53045
Phone 262 784-3200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2024
Certificate Expiration Date 4/20/2026
Facility Type Physician Office
Lab Director DR. LORELLE M. MANION

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