52D2297845 CLIA NUMBER - VIN BAKER RECOVERY LLC

Laboratory Demographics

  • CLIA Code: 52D2297845
  • Facility Name: VIN BAKER RECOVERY LLC
  • Facility Address: 4757 N 76TH STREET
    MILWAUKEE, WI
    ZIP 53218
  • Facility Phone: 414 539-6999
  • Facility Type: Other - OPIOID TREATMENT PROGRAM
  • Facility Type: Waiver
  • Lab Director: DR. TEDDY THOMPSON
  • NPI Number: 1649951708
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2297845
LAB Type Other - OPIOID TREATMENT PROGRAM
Facility Name VIN BAKER RECOVERY LLC
Street 4757 N 76TH STREET
City MILWAUKEE
State WI
ZIP 53218
Phone 414 539-6999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2024
Certificate Expiration Date 1/22/2026
Facility Type Other - OPIOID TREATMENT PROGRAM
Lab Director DR. TEDDY THOMPSON

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