52D2235125 CLIA NUMBER - DUBUQUE INTERNAL MEDICINE DBA TRI-STATE DIALYSIS

Laboratory Demographics

  • CLIA Code: 52D2235125
  • Facility Name: DUBUQUE INTERNAL MEDICINE DBA TRI-STATE DIALYSIS
  • Facility Address: 190 NORTH ORANGE ST
    RICHLAND CENTER, WI
    ZIP 53581
  • Facility Phone: 608 383-7020
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: TAMMY L. SCHOLL
  • NPI Number: 1679171599
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2235125
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DUBUQUE INTERNAL MEDICINE DBA TRI-STATE DIALYSIS
Street 190 NORTH ORANGE ST
City RICHLAND CENTER
State WI
ZIP 53581
Phone 608 383-7020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/7/2025
Certificate Expiration Date 9/6/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director TAMMY L. SCHOLL

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