52D2239876 CLIA NUMBER - GRANTSBURG SCHOOL DISTRICT

Laboratory Demographics

  • CLIA Code: 52D2239876
  • Facility Name: GRANTSBURG SCHOOL DISTRICT
  • Facility Address: 480 E JAMES AVE
    GRANTSBURG, WI
    ZIP 54840
  • Facility Phone: 715 463-2320
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: KAYLA R. BISTRAM
  • NPI Number: 1174653133
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 52D2239876
LAB Type School/Student Health Service
Facility Name GRANTSBURG SCHOOL DISTRICT
Street 480 E JAMES AVE
City GRANTSBURG
State WI
ZIP 54840
Phone 715 463-2320
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2023
Certificate Expiration Date 10/13/2025
Facility Type School/Student Health Service
Lab Director KAYLA R. BISTRAM

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