52D2173003 CLIA NUMBER - EVANSVILLE EMS

Laboratory Demographics

CLIA Number: 52D2173003

Facility Name: EVANSVILLE EMS

Facility Address:
22 W CHURCH ST
EVANSVILLE, WI
ZIP 53536
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Facility Phone Number: 608 882-2269

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1376597922

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	52D2173003
LAB Type	Ambulance
Facility Name	EVANSVILLE EMS
Street	22 W CHURCH ST
City	EVANSVILLE
State	WI
ZIP	53536
Phone	608 882-2269
CertificateType	4
CertificateEffectiveDate	10/3/2023
CertificateExpirationDate	10/2/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024