52D2239787 CLIA NUMBER - ITHACA SCHOOL DISTRICT

Laboratory Demographics

  • CLIA Code: 52D2239787
  • Facility Name: ITHACA SCHOOL DISTRICT
  • Facility Address: 24615 STATE HIGHWAY 58
    RICHLAND CENTER, WI
    ZIP 53581
  • Facility Phone: 608 585-2512
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: SAMANTHA J. WILSON
  • NPI Number: 1073771341
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 52D2239787
LAB Type School/Student Health Service
Facility Name ITHACA SCHOOL DISTRICT
Street 24615 STATE HIGHWAY 58
City RICHLAND CENTER
State WI
ZIP 53581
Phone 608 585-2512
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2024
Certificate Expiration Date 8/26/2026
Facility Type School/Student Health Service
Lab Director SAMANTHA J. WILSON

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