52D2018007 CLIA NUMBER - HO-CHUNK HEALTH CARE CENTER - COMMUNITY HEALTH

Laboratory Demographics

  • CLIA Code: 52D2018007
  • Facility Name: HO-CHUNK HEALTH CARE CENTER - COMMUNITY HEALTH
  • Facility Address: COMMUNITY HEALTH OFFICE/ ATTN SARA PETERSON W9850 AIRPORT ROAD
    BLACK RIVER FALLS, WI
    ZIP 54615
  • Facility Phone: (715) 284-9851
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: DR. CHANDRA S. REDDY
  • NPI Number: 1639553100
  • Taxonomy: 305R00000X - Preferred Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 52D2018007
LAB Type Home Health Agency
Facility Name HO-CHUNK HEALTH CARE CENTER - COMMUNITY HEALTH
Street COMMUNITY HEALTH OFFICE/ ATTN SARA PETERSON W9850 AIRPORT ROAD
City BLACK RIVER FALLS
State WI
ZIP 54615
Phone 7152849851
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Home Health Agency
Lab Director DR. CHANDRA S. REDDY

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This page was last updated on: 5/18/2026