52D2212447 CLIA NUMBER - BLANDINE HOUSE INC

Laboratory Demographics

  • CLIA Code: 52D2212447
  • Facility Name: BLANDINE HOUSE INC
  • Facility Address: 25 N PARK AVE
    FOND DU LAC, WI
    ZIP 54935
  • Facility Phone: 920 922-9487
  • Facility Type: Other - SUBSTANCE ABUST TX
  • Facility Type: Waiver
  • Lab Director: MS. JULIE K. FEILBACH
  • NPI Number: 1285922971
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2212447
LAB Type Other - SUBSTANCE ABUST TX
Facility Name BLANDINE HOUSE INC
Street 25 N PARK AVE
City FOND DU LAC
State WI
ZIP 54935
Phone 920 922-9487
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Other - SUBSTANCE ABUST TX
Lab Director MS. JULIE K. FEILBACH

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