52D2209703 CLIA NUMBER - METHODIST MANOR INC

Laboratory Demographics

  • CLIA Code: 52D2209703
  • Facility Name: METHODIST MANOR INC
  • Facility Address: 3023 S 84TH ST
    WEST ALLIS, WI
    ZIP 53227
  • Facility Phone: 414 607-4100
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DR. KESHNI RAMNANAN
  • NPI Number: 1649247453
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2209703
LAB Type Assisted Living Facility
Facility Name METHODIST MANOR INC
Street 3023 S 84TH ST
City WEST ALLIS
State WI
ZIP 53227
Phone 414 607-4100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2025
Certificate Expiration Date 1/14/2027
Facility Type Assisted Living Facility
Lab Director DR. KESHNI RAMNANAN

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