52D2250852 CLIA NUMBER - ST ELIZABETH MANOR

Laboratory Demographics

  • CLIA Code: 52D2250852
  • Facility Name: ST ELIZABETH MANOR
  • Facility Address: 111 COMMERCIAL DR
    FOOTVILLE, WI
    ZIP 53537
  • Facility Phone: 608 876-4000
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER L. FRAASE
  • NPI Number: 1295340016
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D2250852
LAB Type Assisted Living Facility
Facility Name ST ELIZABETH MANOR
Street 111 COMMERCIAL DR
City FOOTVILLE
State WI
ZIP 53537
Phone 608 876-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Assisted Living Facility
Lab Director JENNIFER L. FRAASE

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