52D2116580 CLIA NUMBER - ELEVATE, INC

Laboratory Demographics

  • CLIA Code: 52D2116580
  • Facility Name: ELEVATE, INC
  • Facility Address: N169 W21005 MEADOW LN
    JACKSON, WI
    ZIP 53037
  • Facility Phone: 262 667-2614
  • Facility Type: Other - COMMUNITY RESOURCE CENTER
  • Facility Type: Waiver
  • Lab Director: MS. MARY S. SIMON
  • NPI Number: 1548047681
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 52D2116580
LAB Type Other - COMMUNITY RESOURCE CENTER
Facility Name ELEVATE, INC
Street N169 W21005 MEADOW LN
City JACKSON
State WI
ZIP 53037
Phone 262 667-2614
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Other - COMMUNITY RESOURCE CENTER
Lab Director MS. MARY S. SIMON

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