52D2114304 CLIA NUMBER - BJOSC AT PLOVER, LLC

Laboratory Demographics

  • CLIA Code: 52D2114304
  • Facility Name: BJOSC AT PLOVER, LLC
  • Facility Address: 1767 PARK AVE, STE 300
    PLOVER, WI
    ZIP 54467
  • Facility Phone: 715 344-1260
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. SCOTT D. STUEMPFIG
  • NPI Number: 1477900710
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2114304
LAB Type Ambulatory Surgery Center
Facility Name BJOSC AT PLOVER, LLC
Street 1767 PARK AVE, STE 300
City PLOVER
State WI
ZIP 54467
Phone 715 344-1260
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2024
Certificate Expiration Date 6/9/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. SCOTT D. STUEMPFIG

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