52D2013392 CLIA NUMBER - PINE RIDGE SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 52D2013392
  • Facility Name: PINE RIDGE SURGERY CENTER, LLC
  • Facility Address: 2500 PINE RIDGE BLVD
    WAUSAU, WI
    ZIP 54401
  • Facility Phone: 715 843-1019
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. GARY T. SWEET
  • NPI Number: 1669787958
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2013392
LAB Type Ambulatory Surgery Center
Facility Name PINE RIDGE SURGERY CENTER, LLC
Street 2500 PINE RIDGE BLVD
City WAUSAU
State WI
ZIP 54401
Phone 715 843-1019
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. GARY T. SWEET

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