52D1058242 CLIA NUMBER - MONROE CLINIC DIALYSIS LIBERTY DIALYSIS AFFILIATE

Laboratory Demographics

  • CLIA Code: 52D1058242
  • Facility Name: MONROE CLINIC DIALYSIS LIBERTY DIALYSIS AFFILIATE
  • Facility Address: 120 WEST 7TH STREET
    MONROE, WI
    ZIP 53566
  • Facility Phone: 608 324-1952
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ELIZABETH TEASDALE
  • NPI Number: 1396800595
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 52D1058242
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MONROE CLINIC DIALYSIS LIBERTY DIALYSIS AFFILIATE
Street 120 WEST 7TH STREET
City MONROE
State WI
ZIP 53566
Phone 608 324-1952
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ELIZABETH TEASDALE

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