52D2090369 CLIA NUMBER - WAUKESHA COUNTY DEPT OF HEALTH & HUMAN SERVICES

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Laboratory Demographics

CLIA Number: 52D2090369

Facility Name: WAUKESHA COUNTY DEPT OF HEALTH & HUMAN SERVICES

Facility Address:
514 RIVERVIEW AVE
WAUKESHA, WI
ZIP 53188
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Facility Phone Number: 262 548-7665

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1174655567

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	52D2090369
LAB Type	Community Clinic
Facility Name	WAUKESHA COUNTY DEPT OF HEALTH & HUMAN SERVICES
Street	514 RIVERVIEW AVE
City	WAUKESHA
State	WI
ZIP	53188
Phone	262 548-7665
CertificateType	4
CertificateEffectiveDate	1/22/2023
CertificateExpirationDate	1/21/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024