52D2251309 CLIA NUMBER - WATERFORD PLACE

Laboratory Demographics

  • CLIA Code: 52D2251309
  • Facility Name: WATERFORD PLACE
  • Facility Address: 808 CORNERSTONE CROSSING
    WATERFORD, WI
    ZIP 53185
  • Facility Phone: 262 352-4702
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: NICOLE L. KUNZE
  • NPI Number: 1316081441
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2251309
LAB Type Assisted Living Facility
Facility Name WATERFORD PLACE
Street 808 CORNERSTONE CROSSING
City WATERFORD
State WI
ZIP 53185
Phone 262 352-4702
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2024
Certificate Expiration Date 2/1/2026
Facility Type Assisted Living Facility
Lab Director NICOLE L. KUNZE

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