52D1033508 CLIA NUMBER - QUALITY ADDICTION MANAGEMENT

Laboratory Demographics

  • CLIA Code: 52D1033508
  • Facility Name: QUALITY ADDICTION MANAGEMENT
  • Facility Address: 1610 MILLER PARK WAY
    WEST MILWAUKEE, WI
    ZIP 53214
  • Facility Phone: 414 672-3801
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. KEVIN WEIDMAN
  • NPI Number: 1659522613
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D1033508
LAB Type Physician Office
Facility Name QUALITY ADDICTION MANAGEMENT
Street 1610 MILLER PARK WAY
City WEST MILWAUKEE
State WI
ZIP 53214
Phone 414 672-3801
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Physician Office
Lab Director DR. KEVIN WEIDMAN

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