52D2029033 CLIA NUMBER - VASCARE MAYFAIR LLC

Laboratory Demographics

  • CLIA Code: 52D2029033
  • Facility Name: VASCARE MAYFAIR LLC
  • Facility Address: 805 N MAYFAIR RD
    WAUWATOSA, WI
    ZIP 53226
  • Facility Phone: 414 988-6773
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. GREGG M. GAYLORD
  • NPI Number: 1477848992
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2029033
LAB Type Ambulatory Surgery Center
Facility Name VASCARE MAYFAIR LLC
Street 805 N MAYFAIR RD
City WAUWATOSA
State WI
ZIP 53226
Phone 414 988-6773
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2023
Certificate Expiration Date 8/29/2025
Facility Type Ambulatory Surgery Center
Lab Director DR. GREGG M. GAYLORD

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