52D2164431 CLIA NUMBER - FOOTVILLE FIRE DEPT & EMS

Laboratory Demographics

  • CLIA Code: 52D2164431
  • Facility Name: FOOTVILLE FIRE DEPT & EMS
  • Facility Address: 252 N GILBERT ST
    FOOTVILLE, WI
    ZIP 53537
  • Facility Phone: 608 876-6118
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MR. JERAMIE MIELKE
  • NPI Number: 1003019704
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 52D2164431
LAB Type Ambulance
Facility Name FOOTVILLE FIRE DEPT & EMS
Street 252 N GILBERT ST
City FOOTVILLE
State WI
ZIP 53537
Phone 608 876-6118
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2025
Certificate Expiration Date 4/3/2027
Facility Type Ambulance
Lab Director MR. JERAMIE MIELKE

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