52D2245281 CLIA NUMBER - NORTHWEST PASSAGE, LTD

Laboratory Demographics

  • CLIA Code: 52D2245281
  • Facility Name: NORTHWEST PASSAGE, LTD
  • Facility Address: 203 UNITED WAY DR
    FREDERIC, WI
    ZIP 54837
  • Facility Phone: 715 372-4402
  • Facility Type: Other - TREATMENT FACILITY
  • Facility Type: Waiver
  • Lab Director: DR. DAVID A. AMMEND
  • NPI Number: 1770985467
  • Taxonomy: 261QM0855X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2245281
LAB Type Other - TREATMENT FACILITY
Facility Name NORTHWEST PASSAGE, LTD
Street 203 UNITED WAY DR
City FREDERIC
State WI
ZIP 54837
Phone 715 372-4402
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2023
Certificate Expiration Date 12/9/2025
Facility Type Other - TREATMENT FACILITY
Lab Director DR. DAVID A. AMMEND

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This page was last updated on: 6/4/2025