52D2079627 CLIA NUMBER - ADVANCED CARE FOR WOMEN

Laboratory Demographics

  • CLIA Code: 52D2079627
  • Facility Name: ADVANCED CARE FOR WOMEN
  • Facility Address: 2411 HOLMGREN WAY
    GREEN BAY, WI
    ZIP 54304
  • Facility Phone: 920 888-2828
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. HERBERT S. COUSSONS
  • NPI Number: 1770957813
  • Taxonomy: 207VB0002X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 52D2079627
LAB Type Physician Office
Facility Name ADVANCED CARE FOR WOMEN
Street 2411 HOLMGREN WAY
City GREEN BAY
State WI
ZIP 54304
Phone 920 888-2828
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/21/2024
Certificate Expiration Date 6/20/2026
Facility Type Physician Office
Lab Director DR. HERBERT S. COUSSONS

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