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52D1082577 CLIA NUMBER - ST NICHOLAS HOSPITAL - SHEBOYGAN SURGERY CENTER

Laboratory Demographics

CLIA Number: 52D1082577

Facility Name: ST NICHOLAS HOSPITAL - SHEBOYGAN SURGERY CENTER

Facility Address:
3141 SAEMANN AVE
SHEBOYGAN, WI
ZIP 53081
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Facility Phone Number: 920 783-1250

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver
NPI Number: 1447737762

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 52D1082577
LAB Type Ambulatory Surgery Center
Facility Name ST NICHOLAS HOSPITAL - SHEBOYGAN SURGERY CENTER
Street 3141 SAEMANN AVE
City SHEBOYGAN
State WI
ZIP 53081
Phone 920 783-1250
CertificateType 4
CertificateEffectiveDate 5/3/2023
CertificateExpirationDate 5/2/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024