52D2128477 CLIA NUMBER - PSYCHOLOGICAL ADDICTION SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 52D2128477
  • Facility Name: PSYCHOLOGICAL ADDICTION SERVICES, LLC
  • Facility Address: 3113 E WASHINGTON AVE
    MADISON, WI
    ZIP 53704
  • Facility Phone: 608 416-5777
  • Facility Type: Other - SUBSTANCE ABUSE TREATMENT
  • Facility Type: Waiver
  • Lab Director: DAVID WAGNER
  • NPI Number: 1881131761
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2128477
LAB Type Other - SUBSTANCE ABUSE TREATMENT
Facility Name PSYCHOLOGICAL ADDICTION SERVICES, LLC
Street 3113 E WASHINGTON AVE
City MADISON
State WI
ZIP 53704
Phone 608 416-5777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Other - SUBSTANCE ABUSE TREATMENT
Lab Director DAVID WAGNER

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