52D2050006 CLIA NUMBER - NEWCASTLE PLACE, LLC

Laboratory Demographics

  • CLIA Code: 52D2050006
  • Facility Name: NEWCASTLE PLACE, LLC
  • Facility Address: 12600 N PORT WASHINGTON RD
    MEQUON, WI
    ZIP 53092
  • Facility Phone: 515 875-4590
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MR. TYLER R. GUDEX
  • NPI Number: 1093799272
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2050006
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name NEWCASTLE PLACE, LLC
Street 12600 N PORT WASHINGTON RD
City MEQUON
State WI
ZIP 53092
Phone 515 875-4590
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2024
Certificate Expiration Date 11/18/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MR. TYLER R. GUDEX

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