52D2038421 CLIA NUMBER - TOWER CLOCK SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 52D2038421
  • Facility Name: TOWER CLOCK SURGERY CENTER
  • Facility Address: 1077 W MASON ST
    GREEN BAY, WI
    ZIP 54303
  • Facility Phone: 920 497-1810
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MS. STACY M. RUKAMP
  • NPI Number: 1437427333
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2038421
LAB Type Ambulatory Surgery Center
Facility Name TOWER CLOCK SURGERY CENTER
Street 1077 W MASON ST
City GREEN BAY
State WI
ZIP 54303
Phone 920 497-1810
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/20/2024
Certificate Expiration Date 3/19/2026
Facility Type Ambulatory Surgery Center
Lab Director MS. STACY M. RUKAMP

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