52D2139215 CLIA NUMBER - DREXEL TOWN SQUARE SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 52D2139215
  • Facility Name: DREXEL TOWN SQUARE SURGERY CENTER, LLC
  • Facility Address: 7901 SOUTH 6TH STREET 2ND FLOOR
    OAK CREEK, WI
    ZIP 53154
  • Facility Phone: 414 805-9500
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TAMMY WILSON
  • NPI Number: 1942722798
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2139215
LAB Type Ambulatory Surgery Center
Facility Name DREXEL TOWN SQUARE SURGERY CENTER, LLC
Street 7901 SOUTH 6TH STREET 2ND FLOOR
City OAK CREEK
State WI
ZIP 53154
Phone 414 805-9500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Ambulatory Surgery Center
Lab Director TAMMY WILSON

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