52D2199255 CLIA NUMBER - DEER PATH INTEGRATED LIVING, INC

Laboratory Demographics

CLIA Code: 52D2199255
Facility Name: DEER PATH INTEGRATED LIVING, INC
Facility Address: N9895 18TH AVENUE
NECEDAH, WI
ZIP 54646
Facility Phone: 608 547-4444
Facility Type: Assisted Living Facility
Facility Type: Waiver
Lab Director: MS. LISA R. GREGAR
NPI Number: 1366328320
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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CLIA Record

Field Name	Field Value
CLIA Number	52D2199255
LAB Type	Assisted Living Facility
Facility Name	DEER PATH INTEGRATED LIVING, INC
Street	N9895 18TH AVENUE
City	NECEDAH
State	WI
ZIP	54646
Phone	608 547-4444
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	11/6/2024
Certificate Expiration Date	11/5/2026
Facility Type	Assisted Living Facility
Lab Director	MS. LISA R. GREGAR

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