52D2178746 CLIA NUMBER - EDENBROOK MEADOWS ASSISTED LIVING, LLC

Laboratory Demographics

  • CLIA Code: 52D2178746
  • Facility Name: EDENBROOK MEADOWS ASSISTED LIVING, LLC
  • Facility Address: 154 S PIONEER PARKWAY
    FOND DU LAC, WI
    ZIP 54935
  • Facility Phone: 920 921-3993
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: KRYSTAL BITTNER
  • NPI Number: 1740922095
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2178746
LAB Type Assisted Living Facility
Facility Name EDENBROOK MEADOWS ASSISTED LIVING, LLC
Street 154 S PIONEER PARKWAY
City FOND DU LAC
State WI
ZIP 54935
Phone 920 921-3993
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2024
Certificate Expiration Date 2/6/2026
Facility Type Assisted Living Facility
Lab Director KRYSTAL BITTNER

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