52D1040352 CLIA NUMBER - MILWAUKEE HEALTH SERVICE SYSTEMS, LLC DBA RIVER'S SHORE COMPREHENSIVE TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 52D1040352
  • Facility Name: MILWAUKEE HEALTH SERVICE SYSTEMS, LLC DBA RIVER'S SHORE COMPREHENSIVE TREATMENT CENTER
  • Facility Address: 3707 N RICHARDS ST
    MILWAUKEE, WI
    ZIP 53212
  • Facility Phone: 414 967-7006
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: DR. ILVA VAN VALKENBURGH
  • NPI Number: 1972980217
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D1040352
LAB Type Comp. Outpatient Rehab Facility
Facility Name MILWAUKEE HEALTH SERVICE SYSTEMS, LLC DBA RIVER'S SHORE COMPREHENSIVE TREATMENT CENTER
Street 3707 N RICHARDS ST
City MILWAUKEE
State WI
ZIP 53212
Phone 414 967-7006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2023
Certificate Expiration Date 12/29/2025
Facility Type Comp. Outpatient Rehab Facility
Lab Director DR. ILVA VAN VALKENBURGH

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