52D1105748 CLIA NUMBER - SHORES OF SHEBOYGAN ASSISTED LIVING I, THE

Laboratory Demographics

  • CLIA Code: 52D1105748
  • Facility Name: SHORES OF SHEBOYGAN ASSISTED LIVING I, THE
  • Facility Address: 3315 SUPERIOR AVE
    SHEBOYGAN, WI
    ZIP 53081
  • Facility Phone: 920 457-4000
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MICHELLE DAUB

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CLIA Record

Field Name Field Value
CLIA Number 52D1105748
LAB Type Assisted Living Facility
Facility Name SHORES OF SHEBOYGAN ASSISTED LIVING I, THE
Street 3315 SUPERIOR AVE
City SHEBOYGAN
State WI
ZIP 53081
Phone 920 457-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2023
Certificate Expiration Date 9/27/2025
Facility Type Assisted Living Facility
Lab Director MICHELLE DAUB

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This page was last updated on: 6/4/2025