52D2025014 CLIA NUMBER - WEST GROVE CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 52D2025014
  • Facility Name: WEST GROVE CLINIC, LLC
  • Facility Address: 10012 W CAPITOL DR #101
    WAUWATOSA, WI
    ZIP 53222
  • Facility Phone: 414 810-4844
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SELAHATTIN S. KURTER
  • NPI Number: 1518167477
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2025014
LAB Type Physician Office
Facility Name WEST GROVE CLINIC, LLC
Street 10012 W CAPITOL DR #101
City WAUWATOSA
State WI
ZIP 53222
Phone 414 810-4844
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2025
Certificate Expiration Date 5/30/2027
Facility Type Physician Office
Lab Director DR. SELAHATTIN S. KURTER

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