52D1106467 CLIA NUMBER - THEDACARE PHYSICIANS APPLETON NORTH

Laboratory Demographics

  • CLIA Code: 52D1106467
  • Facility Name: THEDACARE PHYSICIANS APPLETON NORTH
  • Facility Address: 2500 E CAPITOL DR
    APPLETON, WI
    ZIP 54911
  • Facility Phone: 920 380-4922
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CRAIG HENDEL
  • NPI Number: 1306959515
  • Taxonomy: 101Y00000X - Counselor

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D1106467
LAB Type Physician Office
Facility Name THEDACARE PHYSICIANS APPLETON NORTH
Street 2500 E CAPITOL DR
City APPLETON
State WI
ZIP 54911
Phone 920 380-4922
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2025
Certificate Expiration Date 10/13/2027
Facility Type Physician Office
Lab Director DR. CRAIG HENDEL

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