52D1048964 CLIA NUMBER - WISCONSIN RESOURCE CENTER

Laboratory Demographics

  • CLIA Code: 52D1048964
  • Facility Name: WISCONSIN RESOURCE CENTER
  • Facility Address: 1505 NORTH DR PO BOX 16
    WINNEBAGO, WI
    ZIP 54985
  • Facility Phone: 920 426-4310
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: DR. THOMAS J. MICHLOWSKI
  • NPI Number: 1669142949
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 52D1048964
LAB Type Other
Facility Name WISCONSIN RESOURCE CENTER
Street 1505 NORTH DR PO BOX 16
City WINNEBAGO
State WI
ZIP 54985
Phone 920 426-4310
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2023
Certificate Expiration Date 12/15/2025
Facility Type Other
Lab Director DR. THOMAS J. MICHLOWSKI

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