52D1104794 CLIA NUMBER - GRANCARE GARDENS ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 52D1104794
  • Facility Name: GRANCARE GARDENS ASSISTED LIVING
  • Facility Address: 1551 DOUSMAN ST
    GREEN BAY, WI
    ZIP 54303
  • Facility Phone: 920 494-3080
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: BRITTANY COBB
  • NPI Number: 1689671109
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D1104794
LAB Type Assisted Living Facility
Facility Name GRANCARE GARDENS ASSISTED LIVING
Street 1551 DOUSMAN ST
City GREEN BAY
State WI
ZIP 54303
Phone 920 494-3080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2025
Certificate Expiration Date 9/9/2027
Facility Type Assisted Living Facility
Lab Director BRITTANY COBB

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