52D2132646 CLIA NUMBER - BELLIN HEALTH TITLETOWN SPORTS MEDICINE AND ORTHOPEDICS

Laboratory Demographics

  • CLIA Code: 52D2132646
  • Facility Name: BELLIN HEALTH TITLETOWN SPORTS MEDICINE AND ORTHOPEDICS
  • Facility Address: 1970 S RIDGE ROAD
    GREEN BAY, WI
    ZIP 54304
  • Facility Phone: 920 430-4888
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. JAMES GAST
  • NPI Number: 1992808166
  • Taxonomy: 261QP2000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2132646
LAB Type Physician Office
Facility Name BELLIN HEALTH TITLETOWN SPORTS MEDICINE AND ORTHOPEDICS
Street 1970 S RIDGE ROAD
City GREEN BAY
State WI
ZIP 54304
Phone 920 430-4888
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/10/2024
Certificate Expiration Date 4/9/2026
Facility Type Physician Office
Lab Director DR. JAMES GAST

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This page was last updated on: 3/20/2025