52D2101063 CLIA NUMBER - AZURA MEMORY CARE - KENOSHA BLUE

Laboratory Demographics

  • CLIA Code: 52D2101063
  • Facility Name: AZURA MEMORY CARE - KENOSHA BLUE
  • Facility Address: 4600 52ND AVE BLDG #2 (B)
    KENOSHA, WI
    ZIP 53144
  • Facility Phone: 262 654-5183
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JAMIE REPA

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CLIA Record

Field Name Field Value
CLIA Number 52D2101063
LAB Type Assisted Living Facility
Facility Name AZURA MEMORY CARE - KENOSHA BLUE
Street 4600 52ND AVE BLDG #2 (B)
City KENOSHA
State WI
ZIP 53144
Phone 262 654-5183
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2023
Certificate Expiration Date 8/26/2025
Facility Type Assisted Living Facility
Lab Director JAMIE REPA

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