52D1105742 CLIA NUMBER - STOUGHTON MEADOWS ASSISTED LIVING

Laboratory Demographics

CLIA Number: 52D1105742

Facility Name: STOUGHTON MEADOWS ASSISTED LIVING

Facility Address:
2321 JACKSON ST
STOUGHTON, WI
ZIP 53589
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Facility Phone Number: 608 877-1227

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1811590557

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	52D1105742
LAB Type	Assisted Living Facility
Facility Name	STOUGHTON MEADOWS ASSISTED LIVING
Street	2321 JACKSON ST
City	STOUGHTON
State	WI
ZIP	53589
Phone	608 877-1227
CertificateType	4
CertificateEffectiveDate	9/28/2023
CertificateExpirationDate	9/27/2025
FacilityType	Waiver

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