52D2173792 CLIA NUMBER - ENT & ALLERGY ASSOCIATES SC

Laboratory Demographics

  • CLIA Code: 52D2173792
  • Facility Name: ENT & ALLERGY ASSOCIATES SC
  • Facility Address: 512 S 28TH AVE
    WAUSAU, WI
    ZIP 54401
  • Facility Phone: 715 847-2021
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DAVID A. EDMONDSON
  • NPI Number: 1255384301
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 52D2173792
LAB Type Physician Office
Facility Name ENT & ALLERGY ASSOCIATES SC
Street 512 S 28TH AVE
City WAUSAU
State WI
ZIP 54401
Phone 715 847-2021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2025
Certificate Expiration Date 10/17/2027
Facility Type Physician Office
Lab Director DR. DAVID A. EDMONDSON

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