52D2084866 CLIA NUMBER - WEST BEND HEALTH AND WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 52D2084866
  • Facility Name: WEST BEND HEALTH AND WELLNESS CENTER
  • Facility Address: 1900 S 18TH AVE
    WEST BEND, WI
    ZIP 53095
  • Facility Phone: 262 338-1427
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. COURTNEY YOUNG
  • NPI Number: 1326057795
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 52D2084866
LAB Type Physician Office
Facility Name WEST BEND HEALTH AND WELLNESS CENTER
Street 1900 S 18TH AVE
City WEST BEND
State WI
ZIP 53095
Phone 262 338-1427
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2025
Certificate Expiration Date 6/29/2027
Facility Type Physician Office
Lab Director DR. COURTNEY YOUNG

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