52D1057000 CLIA NUMBER - SOLIDARITUS FHC - SHEBOYGAN

Laboratory Demographics

  • CLIA Code: 52D1057000
  • Facility Name: SOLIDARITUS FHC - SHEBOYGAN
  • Facility Address: 615 PENNSYLVANIA AVE
    SHEBOYGAN, WI
    ZIP 53081
  • Facility Phone: 202 256-4116
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. SUZANNE GEHL
  • NPI Number: 1396070876
  • Taxonomy: 261QC1800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D1057000
LAB Type Physician Office
Facility Name SOLIDARITUS FHC - SHEBOYGAN
Street 615 PENNSYLVANIA AVE
City SHEBOYGAN
State WI
ZIP 53081
Phone 202 256-4116
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director DR. SUZANNE GEHL

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