52D2062148 CLIA NUMBER - PRIDE TLC

Laboratory Demographics

  • CLIA Code: 52D2062148
  • Facility Name: PRIDE TLC
  • Facility Address: 7805 BIRCH ST
    WESTON, WI
    ZIP 54476
  • Facility Phone: 715 298-3833
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MS. NATTHANICHA KLINSRISUK
  • NPI Number: 1306281258
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2062148
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PRIDE TLC
Street 7805 BIRCH ST
City WESTON
State WI
ZIP 54476
Phone 715 298-3833
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MS. NATTHANICHA KLINSRISUK

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