52D2207665 CLIA NUMBER - WISCONSIN SPINE AND PAIN SC

Laboratory Demographics

  • CLIA Code: 52D2207665
  • Facility Name: WISCONSIN SPINE AND PAIN SC
  • Facility Address: 2595 DEVELOPMENT DRIVE SUITE 150
    GREEN BAY, WI
    ZIP 54311
  • Facility Phone: 920 838-6426
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RAYMOND S. SOHN
  • NPI Number: 1750303350
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2207665
LAB Type Physician Office
Facility Name WISCONSIN SPINE AND PAIN SC
Street 2595 DEVELOPMENT DRIVE SUITE 150
City GREEN BAY
State WI
ZIP 54311
Phone 920 838-6426
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2024
Certificate Expiration Date 12/29/2026
Facility Type Physician Office
Lab Director DR. RAYMOND S. SOHN

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