52D2157334 CLIA NUMBER - ELIZABETH III HOME

Laboratory Demographics

  • CLIA Code: 52D2157334
  • Facility Name: ELIZABETH III HOME
  • Facility Address: 106 S THIRD STREET
    WATERFORD, WI
    ZIP 53185
  • Facility Phone: 262 342-6928
  • Facility Type: Other - ADULT FAMILY HOME
  • Facility Type: Waiver
  • Lab Director: MS. ADRIANE NELSON
  • NPI Number: 1619619541
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2157334
LAB Type Other - ADULT FAMILY HOME
Facility Name ELIZABETH III HOME
Street 106 S THIRD STREET
City WATERFORD
State WI
ZIP 53185
Phone 262 342-6928
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Other - ADULT FAMILY HOME
Lab Director MS. ADRIANE NELSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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