52D2015502 CLIA NUMBER - INDEPENDENT SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 52D2015502
  • Facility Name: INDEPENDENT SURGERY CENTER, LLC
  • Facility Address: 2751 COMMERCIAL BLVD STE 7
    CHIPPEWA FALLS, WI
    ZIP 54729
  • Facility Phone: 715 797-8310
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. THOMAS M. HARVEY
  • NPI Number: 1043836182
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 52D2015502
LAB Type Ambulatory Surgery Center
Facility Name INDEPENDENT SURGERY CENTER, LLC
Street 2751 COMMERCIAL BLVD STE 7
City CHIPPEWA FALLS
State WI
ZIP 54729
Phone 715 797-8310
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. THOMAS M. HARVEY

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