52D1054864 CLIA NUMBER - QUALITY ADDICTION MANAGEMENT DBA BELOIT COMPREHENSIVE TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 52D1054864
  • Facility Name: QUALITY ADDICTION MANAGEMENT DBA BELOIT COMPREHENSIVE TREATMENT CENTER
  • Facility Address: 2240 PRAIRIE AVE, #10
    BELOIT, WI
    ZIP 53511
  • Facility Phone: 608 361-7200
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: DR. JASON SO
  • NPI Number: 1629282470
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D1054864
LAB Type Mobile Laboratory
Facility Name QUALITY ADDICTION MANAGEMENT DBA BELOIT COMPREHENSIVE TREATMENT CENTER
Street 2240 PRAIRIE AVE, #10
City BELOIT
State WI
ZIP 53511
Phone 608 361-7200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2024
Certificate Expiration Date 6/1/2026
Facility Type Mobile Laboratory
Lab Director DR. JASON SO

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