52D2144321 CLIA NUMBER - LEGACY HOSPICE

Laboratory Demographics

  • CLIA Code: 52D2144321
  • Facility Name: LEGACY HOSPICE
  • Facility Address: 850 ELM GROVE RD
    ELM GROVE, WI
    ZIP 53122
  • Facility Phone: 262 879-8014
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DR. ANILKUMAR DONIPARTHI
  • NPI Number: 1184136939
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 52D2144321
LAB Type Hospice
Facility Name LEGACY HOSPICE
Street 850 ELM GROVE RD
City ELM GROVE
State WI
ZIP 53122
Phone 262 879-8014
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Hospice
Lab Director DR. ANILKUMAR DONIPARTHI

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