52D2057435 CLIA NUMBER - MENOMONIE RCAC, LLC

Laboratory Demographics

  • CLIA Code: 52D2057435
  • Facility Name: MENOMONIE RCAC, LLC
  • Facility Address: 917 22ND AVE NE
    MENOMONIE, WI
    ZIP 54751
  • Facility Phone: 715 231-4980
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. MELINDA D. JOHNSON
  • NPI Number: 1659989739
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2057435
LAB Type Assisted Living Facility
Facility Name MENOMONIE RCAC, LLC
Street 917 22ND AVE NE
City MENOMONIE
State WI
ZIP 54751
Phone 715 231-4980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type Assisted Living Facility
Lab Director MS. MELINDA D. JOHNSON

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