52D2299878 CLIA NUMBER - SEQUOIA INTEGRATIVE MEDICAL SERVICES

Laboratory Demographics

  • CLIA Code: 52D2299878
  • Facility Name: SEQUOIA INTEGRATIVE MEDICAL SERVICES
  • Facility Address: 1746 PAUL DR
    KAUKAUNA, WI
    ZIP 54130
  • Facility Phone: 920 422-7402
  • Facility Type: Other - HOSPITALS AND AL POC TEST
  • Facility Type: Waiver
  • Lab Director: JENNIFER VANDENHEUVEL
  • NPI Number: 1790312171
  • Taxonomy: 207QG0300X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 52D2299878
LAB Type Other - HOSPITALS AND AL POC TEST
Facility Name SEQUOIA INTEGRATIVE MEDICAL SERVICES
Street 1746 PAUL DR
City KAUKAUNA
State WI
ZIP 54130
Phone 920 422-7402
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2024
Certificate Expiration Date 2/27/2026
Facility Type Other - HOSPITALS AND AL POC TEST
Lab Director JENNIFER VANDENHEUVEL

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