52D2068670 CLIA NUMBER - MARQUETTE UNIVERSITY MEDICAL CLINIC-EAST

Laboratory Demographics

  • CLIA Code: 52D2068670
  • Facility Name: MARQUETTE UNIVERSITY MEDICAL CLINIC-EAST
  • Facility Address: 1102 W WISCONSIN AVENUE, SUITE 130
    MILWAUKEE, WI
    ZIP 53233
  • Facility Phone: 414 288-7184
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: DR. ROBIN S. BROWN
  • NPI Number: 1932236726
  • Taxonomy: 261QS1000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2068670
LAB Type School/Student Health Service
Facility Name MARQUETTE UNIVERSITY MEDICAL CLINIC-EAST
Street 1102 W WISCONSIN AVENUE, SUITE 130
City MILWAUKEE
State WI
ZIP 53233
Phone 414 288-7184
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type School/Student Health Service
Lab Director DR. ROBIN S. BROWN

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This page was last updated on: 6/4/2025