52D2200677 CLIA NUMBER - SSM HEALTH MONROE CLINIC MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 52D2200677
  • Facility Name: SSM HEALTH MONROE CLINIC MEDICAL GROUP
  • Facility Address: 225 CHURCH STREET
    STOUGHTON, WI
    ZIP 53589
  • Facility Phone: 608 324-2371
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMY LECLAIR
  • NPI Number: 1699014571
  • Taxonomy: 282NR1301X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 52D2200677
LAB Type Physician Office
Facility Name SSM HEALTH MONROE CLINIC MEDICAL GROUP
Street 225 CHURCH STREET
City STOUGHTON
State WI
ZIP 53589
Phone 608 324-2371
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2024
Certificate Expiration Date 11/16/2026
Facility Type Physician Office
Lab Director AMY LECLAIR

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