52D2156861 CLIA NUMBER - 4TH DIMENSION RECOVERY CENTER'S

Laboratory Demographics

  • CLIA Code: 52D2156861
  • Facility Name: 4TH DIMENSION RECOVERY CENTER'S
  • Facility Address: 1216 N PROSPECT AVE
    MILWAUKEE, WI
    ZIP 53202
  • Facility Phone: 928 499-5687
  • Facility Type: Other - OUTPATIENT TREATMENT
  • Facility Type: Waiver
  • Lab Director: DR. RICHARD SCHAEFER
  • NPI Number: 1538634829
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2156861
LAB Type Other - OUTPATIENT TREATMENT
Facility Name 4TH DIMENSION RECOVERY CENTER'S
Street 1216 N PROSPECT AVE
City MILWAUKEE
State WI
ZIP 53202
Phone 928 499-5687
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2024
Certificate Expiration Date 10/24/2026
Facility Type Other - OUTPATIENT TREATMENT
Lab Director DR. RICHARD SCHAEFER

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This page was last updated on: 6/4/2025