52D2269338 CLIA NUMBER - CONCENTRA - GREEN BAY

Laboratory Demographics

  • CLIA Code: 52D2269338
  • Facility Name: CONCENTRA - GREEN BAY
  • Facility Address: 2920 RAMADA WAY
    GREEN BAY, WI
    ZIP 54304
  • Facility Phone: 920 305-0360
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JESSICA PERSE
  • NPI Number: 1093436164
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2269338
LAB Type Physician Office
Facility Name CONCENTRA - GREEN BAY
Street 2920 RAMADA WAY
City GREEN BAY
State WI
ZIP 54304
Phone 920 305-0360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Physician Office
Lab Director DR. JESSICA PERSE

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