52D1028849 CLIA NUMBER - BROOK GARDENS

Laboratory Demographics

  • CLIA Code: 52D1028849
  • Facility Name: BROOK GARDENS
  • Facility Address: 300 O'NEIL ST
    LAKE MILLS, WI
    ZIP 53551
  • Facility Phone: 920 648-5760
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. JOLENE M. LUCAS
  • NPI Number: 1982891289
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D1028849
LAB Type Assisted Living Facility
Facility Name BROOK GARDENS
Street 300 O'NEIL ST
City LAKE MILLS
State WI
ZIP 53551
Phone 920 648-5760
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Assisted Living Facility
Lab Director MS. JOLENE M. LUCAS

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