52D2192701 CLIA NUMBER - AW PREMIER RADIOLOGY WATER TOWER

Laboratory Demographics

  • CLIA Code: 52D2192701
  • Facility Name: AW PREMIER RADIOLOGY WATER TOWER
  • Facility Address: 2350 N LAKE DR
    MILWAUKEE, WI
    ZIP 53211
  • Facility Phone: 414 296-2540
  • Facility Type: Other - OUTPATIENT DIAGNOSTIC CEN
  • Facility Type: Waiver
  • Lab Director: DR. XIAOLAN CHEN

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CLIA Record

Field Name Field Value
CLIA Number 52D2192701
LAB Type Other - OUTPATIENT DIAGNOSTIC CEN
Facility Name AW PREMIER RADIOLOGY WATER TOWER
Street 2350 N LAKE DR
City MILWAUKEE
State WI
ZIP 53211
Phone 414 296-2540
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Other - OUTPATIENT DIAGNOSTIC CEN
Lab Director DR. XIAOLAN CHEN

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This page was last updated on: 6/4/2025