52D2123171 CLIA NUMBER - EVERSIDE HEALTH SHEBOYGAN FALLS PLANKVIEW CLINIC

Laboratory Demographics

  • CLIA Code: 52D2123171
  • Facility Name: EVERSIDE HEALTH SHEBOYGAN FALLS PLANKVIEW CLINIC
  • Facility Address: 1112 PLANKVIEW GREEN BLVD
    SHEBOYGAN FALLS, WI
    ZIP 53085
  • Facility Phone: 704 529-6161
  • Facility Type: Other - CHRONIC DISEASE MNGT
  • Facility Type: Waiver
  • Lab Director: DR. JOHN REISKYTL
  • NPI Number: 1467183566
  • Taxonomy: 2083P0500X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 52D2123171
LAB Type Other - CHRONIC DISEASE MNGT
Facility Name EVERSIDE HEALTH SHEBOYGAN FALLS PLANKVIEW CLINIC
Street 1112 PLANKVIEW GREEN BLVD
City SHEBOYGAN FALLS
State WI
ZIP 53085
Phone 704 529-6161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Other - CHRONIC DISEASE MNGT
Lab Director DR. JOHN REISKYTL

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