52D2047129 CLIA NUMBER - GREAT LAKES HEALTHCARE, INC D/B/A PRECEPTOR HOSPICE

Laboratory Demographics

  • CLIA Code: 52D2047129
  • Facility Name: GREAT LAKES HEALTHCARE, INC D/B/A PRECEPTOR HOSPICE
  • Facility Address: W175 N11117 STONEWOOD DR, SUITE 100
    GERMANTOWN, WI
    ZIP 53022
  • Facility Phone: 262 293-3951
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: MICHELE KOSINSKI
  • NPI Number: 1992076608
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 52D2047129
LAB Type Hospice
Facility Name GREAT LAKES HEALTHCARE, INC D/B/A PRECEPTOR HOSPICE
Street W175 N11117 STONEWOOD DR, SUITE 100
City GERMANTOWN
State WI
ZIP 53022
Phone 262 293-3951
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Hospice
Lab Director MICHELE KOSINSKI

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