52D2195082 CLIA NUMBER - BLUESTONE PHYSICIAN SERVICES WISCONSIN, SC

Laboratory Demographics

  • CLIA Code: 52D2195082
  • Facility Name: BLUESTONE PHYSICIAN SERVICES WISCONSIN, SC
  • Facility Address: 342 N WATER STREET, SUITE 600
    MILWAUKEE, WI
    ZIP 53202
  • Facility Phone: 651 342-1039
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. RAJIV N. PATEL
  • NPI Number: 1922497908
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 52D2195082
LAB Type Practitioner Other
Facility Name BLUESTONE PHYSICIAN SERVICES WISCONSIN, SC
Street 342 N WATER STREET, SUITE 600
City MILWAUKEE
State WI
ZIP 53202
Phone 651 342-1039
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Practitioner Other
Lab Director DR. RAJIV N. PATEL

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