52D1082472 CLIA NUMBER - BLUEMOUND SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 52D1082472
  • Facility Name: BLUEMOUND SURGERY CENTER
  • Facility Address: N4 W22370 BLUEMOUND RD
    WAUKESHA, WI
    ZIP 53186
  • Facility Phone: 262 970-5600
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. THOMAS KORKOS
  • NPI Number: 1710107743
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D1082472
LAB Type Ambulatory Surgery Center
Facility Name BLUEMOUND SURGERY CENTER
Street N4 W22370 BLUEMOUND RD
City WAUKESHA
State WI
ZIP 53186
Phone 262 970-5600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2024
Certificate Expiration Date 4/9/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. THOMAS KORKOS

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