52D2244231 CLIA NUMBER - HENRY N AMBROOKIAN, JR DDS ORAL & MAXILLOFACIAL SURGERY

Laboratory Demographics

  • CLIA Code: 52D2244231
  • Facility Name: HENRY N AMBROOKIAN, JR DDS ORAL & MAXILLOFACIAL SURGERY
  • Facility Address: 1201 OAK ST STE J
    WEST BEND, WI
    ZIP 53095
  • Facility Phone: 262 334-7172
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: HENRY N. AMBROOKIAN
  • NPI Number: 1295841203
  • Taxonomy: 1223S0112X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 52D2244231
LAB Type Practitioner Other
Facility Name HENRY N AMBROOKIAN, JR DDS ORAL & MAXILLOFACIAL SURGERY
Street 1201 OAK ST STE J
City WEST BEND
State WI
ZIP 53095
Phone 262 334-7172
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Practitioner Other
Lab Director HENRY N. AMBROOKIAN

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