52D2201147 CLIA NUMBER - SILVER LEAF MANOR

Laboratory Demographics

  • CLIA Code: 52D2201147
  • Facility Name: SILVER LEAF MANOR
  • Facility Address: 1310 LINCOLN ST
    KEWAUNEE, WI
    ZIP 54216
  • Facility Phone: 920 388-2204
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MR. KENNETH J. SECOR
  • NPI Number: 1952592065
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2201147
LAB Type Assisted Living Facility
Facility Name SILVER LEAF MANOR
Street 1310 LINCOLN ST
City KEWAUNEE
State WI
ZIP 54216
Phone 920 388-2204
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2024
Certificate Expiration Date 11/18/2026
Facility Type Assisted Living Facility
Lab Director MR. KENNETH J. SECOR

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