52D2273305 CLIA NUMBER - ST CROIX COUNTY JAIL

Laboratory Demographics

  • CLIA Code: 52D2273305
  • Facility Name: ST CROIX COUNTY JAIL
  • Facility Address: 101 CARMICHAEL ROAD
    HUDSON, WI
    ZIP 54016
  • Facility Phone: 423 206-2002
  • Facility Type: Other - JAIL MEDICAL UNIT
  • Facility Type: Waiver
  • Lab Director: TONYA POWELL
  • NPI Number: 1407131618
  • Taxonomy: 1223P0221X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 52D2273305
LAB Type Other - JAIL MEDICAL UNIT
Facility Name ST CROIX COUNTY JAIL
Street 101 CARMICHAEL ROAD
City HUDSON
State WI
ZIP 54016
Phone 423 206-2002
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Other - JAIL MEDICAL UNIT
Lab Director TONYA POWELL

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