52D2074491 CLIA NUMBER - TRADITIONS OF FREDERIC 1

Laboratory Demographics

  • CLIA Code: 52D2074491
  • Facility Name: TRADITIONS OF FREDERIC 1
  • Facility Address: 107 E OAK STREET
    FREDERIC, WI
    ZIP 54837
  • Facility Phone: 715 327-4888
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. JENNIFER BIRD
  • NPI Number: 1588089114
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2074491
LAB Type Assisted Living Facility
Facility Name TRADITIONS OF FREDERIC 1
Street 107 E OAK STREET
City FREDERIC
State WI
ZIP 54837
Phone 715 327-4888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2024
Certificate Expiration Date 3/10/2026
Facility Type Assisted Living Facility
Lab Director MS. JENNIFER BIRD

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