52D2019014 CLIA NUMBER - QUALITY ADDICTION MANAGEMENT

Laboratory Demographics

  • CLIA Code: 52D2019014
  • Facility Name: QUALITY ADDICTION MANAGEMENT
  • Facility Address: 2842 S BUSINESS DRIVE
    SHEBOYGAN, WI
    ZIP 53081
  • Facility Phone: 920 458-6527
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: DR. GREGORY KAFTAN
  • NPI Number: 1629282470
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2019014
LAB Type Mobile Laboratory
Facility Name QUALITY ADDICTION MANAGEMENT
Street 2842 S BUSINESS DRIVE
City SHEBOYGAN
State WI
ZIP 53081
Phone 920 458-6527
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2025
Certificate Expiration Date 1/19/2027
Facility Type Mobile Laboratory
Lab Director DR. GREGORY KAFTAN

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This page was last updated on: 6/4/2025