52D2261775 CLIA NUMBER - CENTER FOR NEUROLOGICAL DISORDERS SC GAMMA THERAPEUTIC CENTER

Laboratory Demographics

  • CLIA Code: 52D2261775
  • Facility Name: CENTER FOR NEUROLOGICAL DISORDERS SC GAMMA THERAPEUTIC CENTER
  • Facility Address: 10750 W HOWARD AVE
    GREENFIELD, WI
    ZIP 53228
  • Facility Phone: 414 460-3195
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NISHIT NIRMAL
  • NPI Number: 1649223041
  • Taxonomy: 2084N0400X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 52D2261775
LAB Type Physician Office
Facility Name CENTER FOR NEUROLOGICAL DISORDERS SC GAMMA THERAPEUTIC CENTER
Street 10750 W HOWARD AVE
City GREENFIELD
State WI
ZIP 53228
Phone 414 460-3195
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2024
Certificate Expiration Date 6/5/2026
Facility Type Physician Office
Lab Director NISHIT NIRMAL

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