52D2284986 CLIA NUMBER - CEDARCREST SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 52D2284986
  • Facility Name: CEDARCREST SURGERY CENTER
  • Facility Address: 2200 CEDARCREST DR SUITE B
    RICE LAKE, WI
    ZIP 54868
  • Facility Phone: 715 520-3877
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KELLY R. FLACH
  • NPI Number: 1376259275
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2284986
LAB Type Ambulatory Surgery Center
Facility Name CEDARCREST SURGERY CENTER
Street 2200 CEDARCREST DR SUITE B
City RICE LAKE
State WI
ZIP 54868
Phone 715 520-3877
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/3/2025
Certificate Expiration Date 7/2/2027
Facility Type Ambulatory Surgery Center
Lab Director KELLY R. FLACH

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