52D1076859 CLIA NUMBER - ONEIDA TRIBE OF INDIANS OF WISCONSIN EMPLOYEE HEALTH NURSING

Laboratory Demographics

  • CLIA Code: 52D1076859
  • Facility Name: ONEIDA TRIBE OF INDIANS OF WISCONSIN EMPLOYEE HEALTH NURSING
  • Facility Address: 701 PACKERLAND DRIVE
    GREEN BAY, WI
    ZIP 54303
  • Facility Phone: 920 405-4492
  • Facility Type: Industrial
  • Facility Type: Waiver
  • Lab Director: MS. MARY J. CORNELISSEN

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CLIA Record

Field Name Field Value
CLIA Number 52D1076859
LAB Type Industrial
Facility Name ONEIDA TRIBE OF INDIANS OF WISCONSIN EMPLOYEE HEALTH NURSING
Street 701 PACKERLAND DRIVE
City GREEN BAY
State WI
ZIP 54303
Phone 920 405-4492
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2023
Certificate Expiration Date 11/26/2025
Facility Type Industrial
Lab Director MS. MARY J. CORNELISSEN

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This page was last updated on: 6/4/2025