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52D2265149 CLIA NUMBER - WILMOT UNION HIGH SCHOOL

Laboratory Demographics

CLIA Number: 52D2265149

Facility Name: WILMOT UNION HIGH SCHOOL

Facility Address:
11112 308TH AVE
WILMOT, WI
ZIP 53192
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Facility Phone Number: 262 862-2351

Facility Type: School/Student Health Service

Certificate Type: Waiver
NPI Number: 1639358500

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 52D2265149
LAB Type School/Student Health Service
Facility Name WILMOT UNION HIGH SCHOOL
Street 11112 308TH AVE
City WILMOT
State WI
ZIP 53192
Phone 262 862-2351
CertificateType 4
CertificateEffectiveDate 7/25/2022
CertificateExpirationDate 7/24/2024
FacilityType Waiver

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