52D1028611 CLIA NUMBER - HERITAGE COURT

Laboratory Demographics

CLIA Number: 52D1028611

Facility Name: HERITAGE COURT

Facility Address:
N78 W14250 W HAMPTON AVENUE
MENOMONEE FALLS, WI
ZIP 53051
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Facility Phone Number: 262 432-0990

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1942821772

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	52D1028611
LAB Type	Assisted Living Facility
Facility Name	HERITAGE COURT
Street	N78 W14250 W HAMPTON AVENUE
City	MENOMONEE FALLS
State	WI
ZIP	53051
Phone	262 432-0990
CertificateType	4
CertificateEffectiveDate	8/13/2023
CertificateExpirationDate	8/12/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024