52D2261426 CLIA NUMBER - ANOVIA HEALTH, SC - GAMBER JOHNSON CLINIC

Laboratory Demographics

CLIA Number: 52D2261426

Facility Name: ANOVIA HEALTH, SC - GAMBER JOHNSON CLINIC

Facility Address:
5001 JOERNS DR
STEVENS POINT, WI
ZIP 54481
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Facility Phone Number: 715 603-6710

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1063175859

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	52D2261426
LAB Type	Community Clinic
Facility Name	ANOVIA HEALTH, SC - GAMBER JOHNSON CLINIC
Street	5001 JOERNS DR
City	STEVENS POINT
State	WI
ZIP	54481
Phone	715 603-6710
CertificateType	4
CertificateEffectiveDate	5/31/2022
CertificateExpirationDate	5/30/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024