52D1032412 CLIA NUMBER - HOSPICE ADVANTAGE, LLC

Laboratory Demographics

  • CLIA Code: 52D1032412
  • Facility Name: HOSPICE ADVANTAGE, LLC
  • Facility Address: 2124 KOHLER MEMORIAL DRIVE, SUITE 200A
    SHEBOYGAN, WI
    ZIP 53081
  • Facility Phone: 920 452-1851
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: MS. SHANNA GONZALES
  • NPI Number: 1467601310
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 52D1032412
LAB Type Hospice
Facility Name HOSPICE ADVANTAGE, LLC
Street 2124 KOHLER MEMORIAL DRIVE, SUITE 200A
City SHEBOYGAN
State WI
ZIP 53081
Phone 920 452-1851
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Hospice
Lab Director MS. SHANNA GONZALES

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