52D2000694 CLIA NUMBER - HERITAGE MONONA

Laboratory Demographics

  • CLIA Code: 52D2000694
  • Facility Name: HERITAGE MONONA
  • Facility Address: 111 OWEN RD
    MONONA, WI
    ZIP 53716
  • Facility Phone: 608 441-2400
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. KIMBERLY M. LANE
  • NPI Number: 1881215895
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2000694
LAB Type Assisted Living Facility
Facility Name HERITAGE MONONA
Street 111 OWEN RD
City MONONA
State WI
ZIP 53716
Phone 608 441-2400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Assisted Living Facility
Lab Director MS. KIMBERLY M. LANE

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This page was last updated on: 9/29/2025