52D2293493 CLIA NUMBER - DRIFTLESS DIABETES MANAGEMENT LLC

Laboratory Demographics

  • CLIA Code: 52D2293493
  • Facility Name: DRIFTLESS DIABETES MANAGEMENT LLC
  • Facility Address: 285 S WINSTED ST
    SPRING GREEN, WI
    ZIP 53588
  • Facility Phone: 608 459-6172
  • Facility Type: Other - PRIVATE PRACTICE CLINIC
  • Facility Type: Waiver
  • Lab Director: JACLYN WILKINSON
  • NPI Number: 1902592157
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 52D2293493
LAB Type Other - PRIVATE PRACTICE CLINIC
Facility Name DRIFTLESS DIABETES MANAGEMENT LLC
Street 285 S WINSTED ST
City SPRING GREEN
State WI
ZIP 53588
Phone 608 459-6172
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Other - PRIVATE PRACTICE CLINIC
Lab Director JACLYN WILKINSON

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