52D2128370 CLIA NUMBER - GENEVA SURGICAL SUITES LLC

Laboratory Demographics

  • CLIA Code: 52D2128370
  • Facility Name: GENEVA SURGICAL SUITES LLC
  • Facility Address: 119 ELIZABETH LANE
    GENOA CITY, WI
    ZIP 53128
  • Facility Phone: 224 678-1080
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. GREGORY N. DRAKE
  • NPI Number: 1447799580
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2128370
LAB Type Ambulatory Surgery Center
Facility Name GENEVA SURGICAL SUITES LLC
Street 119 ELIZABETH LANE
City GENOA CITY
State WI
ZIP 53128
Phone 224 678-1080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. GREGORY N. DRAKE

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