52D2282929 CLIA NUMBER - MEDEXPRESS WAUPACA FOUNDRY - MARINETTE

Laboratory Demographics

  • CLIA Code: 52D2282929
  • Facility Name: MEDEXPRESS WAUPACA FOUNDRY - MARINETTE
  • Facility Address: 3900 HALL AVENUE, SUITE H
    MARINETTE, WI
    ZIP 54143
  • Facility Phone: 715 504-1112
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DAVID R. FERRELL
  • NPI Number: 1194422964
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 52D2282929
LAB Type Physician Office
Facility Name MEDEXPRESS WAUPACA FOUNDRY - MARINETTE
Street 3900 HALL AVENUE, SUITE H
City MARINETTE
State WI
ZIP 54143
Phone 715 504-1112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Physician Office
Lab Director DR. DAVID R. FERRELL

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