52D1053145 CLIA NUMBER - BAYCARE CLINIC, LLP

Laboratory Demographics

CLIA Number: 52D1053145

Facility Name: BAYCARE CLINIC, LLP

Facility Address:
1111 BAYSHORE DR
MANITOWOC, WI
ZIP 54220
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Facility Phone Number: 920 682-6376

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1083237754

Taxonomy: 213E00000X - Podiatrist
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

CLIA Record

Field Name	Field Value
CLIA Number	52D1053145
LAB Type	Physician Office
Facility Name	BAYCARE CLINIC, LLP
Street	1111 BAYSHORE DR
City	MANITOWOC
State	WI
ZIP	54220
Phone	920 682-6376
CertificateType	4
CertificateEffectiveDate	4/14/2024
CertificateExpirationDate	4/13/2026
FacilityType	Waiver

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