52D2198672 CLIA NUMBER - ELIZABETH RESIDENCE, OAK CREEK

Laboratory Demographics

  • CLIA Code: 52D2198672
  • Facility Name: ELIZABETH RESIDENCE, OAK CREEK
  • Facility Address: 10441 S NICHOLSON RD
    OAK CREEK, WI
    ZIP 53154
  • Facility Phone: 414 352-9040
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MR. JOHN M. COURY
  • NPI Number: 1154077337
  • Taxonomy: 101Y00000X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 52D2198672
LAB Type Assisted Living Facility
Facility Name ELIZABETH RESIDENCE, OAK CREEK
Street 10441 S NICHOLSON RD
City OAK CREEK
State WI
ZIP 53154
Phone 414 352-9040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2024
Certificate Expiration Date 11/2/2026
Facility Type Assisted Living Facility
Lab Director MR. JOHN M. COURY

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