52D2159485 CLIA NUMBER - CHILDREN'S WISCONSIN CLINICS KENOSHA

Laboratory Demographics

  • CLIA Code: 52D2159485
  • Facility Name: CHILDREN'S WISCONSIN CLINICS KENOSHA
  • Facility Address: 6809 122ND AVENUE
    KENOSHA, WI
    ZIP 53142
  • Facility Phone: 262 891-6553
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: DR. JASON A. JARZEMBOWSKI
  • NPI Number: 1326217233
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 52D2159485
LAB Type Community Clinic
Facility Name CHILDREN'S WISCONSIN CLINICS KENOSHA
Street 6809 122ND AVENUE
City KENOSHA
State WI
ZIP 53142
Phone 262 891-6553
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 10/16/2025
Certificate Expiration Date 10/15/2027
Facility Type Community Clinic
Lab Director DR. JASON A. JARZEMBOWSKI

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