52D2077854 CLIA NUMBER - AUTUMN'S PROMISE ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 52D2077854
  • Facility Name: AUTUMN'S PROMISE ASSISTED LIVING
  • Facility Address: 1700 SPARTAN RD
    NEW FRANKEN, WI
    ZIP 54229
  • Facility Phone: 920 465-1181
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. NICOLE M. SILTA
  • NPI Number: 1700431178
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2077854
LAB Type Assisted Living Facility
Facility Name AUTUMN'S PROMISE ASSISTED LIVING
Street 1700 SPARTAN RD
City NEW FRANKEN
State WI
ZIP 54229
Phone 920 465-1181
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2024
Certificate Expiration Date 5/14/2026
Facility Type Assisted Living Facility
Lab Director MS. NICOLE M. SILTA

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This page was last updated on: 3/20/2025