52D2177935 CLIA NUMBER - REM WISCONSIN

Laboratory Demographics

  • CLIA Code: 52D2177935
  • Facility Name: REM WISCONSIN
  • Facility Address: 3724 EMERALD DRIVE
    ONALASKA, WI
    ZIP 54650
  • Facility Phone: 608 276-1191
  • Facility Type: Other - ADULT FAMILY HOME
  • Facility Type: Waiver
  • Lab Director: MR. ROBERT E. JOHNSON
  • NPI Number: 1407095151
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 52D2177935
LAB Type Other - ADULT FAMILY HOME
Facility Name REM WISCONSIN
Street 3724 EMERALD DRIVE
City ONALASKA
State WI
ZIP 54650
Phone 608 276-1191
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2024
Certificate Expiration Date 1/21/2026
Facility Type Other - ADULT FAMILY HOME
Lab Director MR. ROBERT E. JOHNSON

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