52D2234021 CLIA NUMBER - NOHC MAGNOLIA MEADOWS LLC

Laboratory Demographics

  • CLIA Code: 52D2234021
  • Facility Name: NOHC MAGNOLIA MEADOWS LLC
  • Facility Address: 1480 N 7TH ST
    MANITOWOC, WI
    ZIP 54220
  • Facility Phone: 920 686-0160
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DOLORES MANTIK
  • NPI Number: 1003427766
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2234021
LAB Type Assisted Living Facility
Facility Name NOHC MAGNOLIA MEADOWS LLC
Street 1480 N 7TH ST
City MANITOWOC
State WI
ZIP 54220
Phone 920 686-0160
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2025
Certificate Expiration Date 8/26/2027
Facility Type Assisted Living Facility
Lab Director DOLORES MANTIK

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