52D1035097 CLIA NUMBER - NOVAMED SURGERY CENTER OF MADISON LP

Laboratory Demographics

CLIA Number: 52D1035097

Facility Name: NOVAMED SURGERY CENTER OF MADISON LP

Facility Address:
1200 JOHN Q HAMMONS DR STE 102
MADISON, WI
ZIP 53717
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Facility Phone Number: 608 827-7705

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1679570774

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	52D1035097
LAB Type	Ambulatory Surgery Center
Facility Name	NOVAMED SURGERY CENTER OF MADISON LP
Street	1200 JOHN Q HAMMONS DR STE 102
City	MADISON
State	WI
ZIP	53717
Phone	608 827-7705
CertificateType	4
CertificateEffectiveDate	12/21/2022
CertificateExpirationDate	12/20/2024
FacilityType	Waiver

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