52D2146414 CLIA NUMBER - GENESIS BEHAVIORAL SERVICES, INC CROSSROADS

Laboratory Demographics

  • CLIA Code: 52D2146414
  • Facility Name: GENESIS BEHAVIORAL SERVICES, INC CROSSROADS
  • Facility Address: 4107 ST CLAIR STREET
    CALEDONIA, WI
    ZIP 53402
  • Facility Phone: 414 377-3021
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. PATRICIA FAULHABER
  • NPI Number: 1164012373
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2146414
LAB Type Assisted Living Facility
Facility Name GENESIS BEHAVIORAL SERVICES, INC CROSSROADS
Street 4107 ST CLAIR STREET
City CALEDONIA
State WI
ZIP 53402
Phone 414 377-3021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Assisted Living Facility
Lab Director MS. PATRICIA FAULHABER

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