52D2167255 CLIA NUMBER - ST CROIX HOSPICE- FREDERIC

Laboratory Demographics

  • CLIA Code: 52D2167255
  • Facility Name: ST CROIX HOSPICE- FREDERIC
  • Facility Address: 107 OAK STREET EAST
    FREDERIC, WI
    ZIP 54837
  • Facility Phone: 715 327-5600
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: MELISSA LEIS
  • NPI Number: 1669585352
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 52D2167255
LAB Type Hospice
Facility Name ST CROIX HOSPICE- FREDERIC
Street 107 OAK STREET EAST
City FREDERIC
State WI
ZIP 54837
Phone 715 327-5600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2025
Certificate Expiration Date 6/4/2027
Facility Type Hospice
Lab Director MELISSA LEIS

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