52D2240139 CLIA NUMBER - FOX CITIES PERFORMING ARTS CENTER

Laboratory Demographics

  • CLIA Code: 52D2240139
  • Facility Name: FOX CITIES PERFORMING ARTS CENTER
  • Facility Address: 400 W COLLEGE AVE
    APPLETON, WI
    ZIP 54911
  • Facility Phone: 920 730-3768
  • Facility Type: Other - PERFORMING ARTS CENTER
  • Facility Type: Waiver
  • Lab Director: GERALD B. HENLEY
  • NPI Number: 1316969363
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 52D2240139
LAB Type Other - PERFORMING ARTS CENTER
Facility Name FOX CITIES PERFORMING ARTS CENTER
Street 400 W COLLEGE AVE
City APPLETON
State WI
ZIP 54911
Phone 920 730-3768
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2023
Certificate Expiration Date 10/17/2025
Facility Type Other - PERFORMING ARTS CENTER
Lab Director GERALD B. HENLEY

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