52D2262666 CLIA NUMBER - INDEPENDENT PHYSICIANS OF WISCONSIN, LLC

Laboratory Demographics

  • CLIA Code: 52D2262666
  • Facility Name: INDEPENDENT PHYSICIANS OF WISCONSIN, LLC
  • Facility Address: 108 PACKERLAND DR STE D1
    GREEN BAY, WI
    ZIP 54303
  • Facility Phone: (920) 545-5109
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. BRIAN S. WOODBRIDGE

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CLIA Record

Field Name Field Value
CLIA Number 52D2262666
LAB Type Physician Office
Facility Name INDEPENDENT PHYSICIANS OF WISCONSIN, LLC
Street 108 PACKERLAND DR STE D1
City GREEN BAY
State WI
ZIP 54303
Phone 9205455109
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2024
Certificate Expiration Date 6/15/2026
Facility Type Physician Office
Lab Director DR. BRIAN S. WOODBRIDGE

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This page was last updated on: 5/18/2026