52D1079316 CLIA NUMBER - HAYWARD VA OUTPATIENT CLINIC

Laboratory Demographics

  • CLIA Code: 52D1079316
  • Facility Name: HAYWARD VA OUTPATIENT CLINIC
  • Facility Address: 15748 COUNTY RD B
    HAYWARD, WI
    ZIP 54843
  • Facility Phone: 715 934-5454
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Accreditation
  • Lab Director: JUSTIN PELTOLA
  • NPI Number: 1235320912
  • Taxonomy: 261QV0200X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D1079316
LAB Type Ambulatory Surgery Center
Facility Name HAYWARD VA OUTPATIENT CLINIC
Street 15748 COUNTY RD B
City HAYWARD
State WI
ZIP 54843
Phone 715 934-5454
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 1/30/2008
Certificate Expiration Date 5/22/2026
Facility Type Ambulatory Surgery Center
Lab Director JUSTIN PELTOLA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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