52D1064179 CLIA NUMBER - RENAISSANCE, THE

Laboratory Demographics

  • CLIA Code: 52D1064179
  • Facility Name: RENAISSANCE, THE
  • Facility Address: 4602 W BARBICAN AVE
    WESTON, WI
    ZIP 54476
  • Facility Phone: 715 355-5858
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: CAROL KUKLINSKI
  • NPI Number: 1578892527
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D1064179
LAB Type Other
Facility Name RENAISSANCE, THE
Street 4602 W BARBICAN AVE
City WESTON
State WI
ZIP 54476
Phone 715 355-5858
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2025
Certificate Expiration Date 1/30/2027
Facility Type Other
Lab Director CAROL KUKLINSKI

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