52D2299697 CLIA NUMBER - QAM, INC DBA MANITOWOC COMPREHENSIVE TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 52D2299697
  • Facility Name: QAM, INC DBA MANITOWOC COMPREHENSIVE TREATMENT CENTER
  • Facility Address: 1100 SOUTH 30TH STREET, SUITE 220
    MANITOWOC, WI
    ZIP 54220
  • Facility Phone: 920 458-6527
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: SARAH NEERDAELS
  • NPI Number: 1700803541
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 52D2299697
LAB Type Comp. Outpatient Rehab Facility
Facility Name QAM, INC DBA MANITOWOC COMPREHENSIVE TREATMENT CENTER
Street 1100 SOUTH 30TH STREET, SUITE 220
City MANITOWOC
State WI
ZIP 54220
Phone 920 458-6527
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2024
Certificate Expiration Date 2/25/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director SARAH NEERDAELS

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