52D2291337 CLIA NUMBER - THEDACARE EMPLOYEE CLINIC - TCA

Laboratory Demographics

  • CLIA Code: 52D2291337
  • Facility Name: THEDACARE EMPLOYEE CLINIC - TCA
  • Facility Address: 1818 N MEADE ST
    APPLETON, WI
    ZIP 54911
  • Facility Phone: 920 454-7850
  • Facility Type: Other - ONSITE EMPLOYER CLINIC
  • Facility Type: Waiver
  • Lab Director: DR. TRACEY ONEAL-HOOKER
  • NPI Number: 1033519046
  • Taxonomy: 302F00000X - Exclusive Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 52D2291337
LAB Type Other - ONSITE EMPLOYER CLINIC
Facility Name THEDACARE EMPLOYEE CLINIC - TCA
Street 1818 N MEADE ST
City APPLETON
State WI
ZIP 54911
Phone 920 454-7850
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2023
Certificate Expiration Date 10/9/2025
Facility Type Other - ONSITE EMPLOYER CLINIC
Lab Director DR. TRACEY ONEAL-HOOKER

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This page was last updated on: 3/20/2025