52D1095709 CLIA NUMBER - SURGICAL ASSOCIATES OF NEENAH SC

Laboratory Demographics

CLIA Number: 52D1095709

Facility Name: SURGICAL ASSOCIATES OF NEENAH SC

Facility Address:
100 THEDA CLARK MEDICAL PLAZA STE 400
NEENAH, WI
ZIP 54956
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Facility Phone Number: 920 725-4527

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1871904888

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	52D1095709
LAB Type	Physician Office
Facility Name	SURGICAL ASSOCIATES OF NEENAH SC
Street	100 THEDA CLARK MEDICAL PLAZA STE 400
City	NEENAH
State	WI
ZIP	54956
Phone	920 725-4527
CertificateType	4
CertificateEffectiveDate	2/16/2023
CertificateExpirationDate	2/15/2025
FacilityType	Waiver

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