52D2011691 CLIA NUMBER - WESTERN WISCONSIN HEALTH ROBERTS

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Laboratory Demographics

CLIA Number: 52D2011691

Facility Name: WESTERN WISCONSIN HEALTH ROBERTS

Facility Address:
503 CHERRY LN
ROBERTS, WI
ZIP 54023
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Facility Phone Number: 715 760-3311

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1447759428

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	52D2011691
LAB Type	Physician Office
Facility Name	WESTERN WISCONSIN HEALTH ROBERTS
Street	503 CHERRY LN
City	ROBERTS
State	WI
ZIP	54023
Phone	715 760-3311
CertificateType	4
CertificateEffectiveDate	3/27/2024
CertificateExpirationDate	3/26/2026
FacilityType	Waiver

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