52D2300414 CLIA NUMBER - UW HEALTH WISCONSIN PSYCHIATRIC INSTITUTE & CLINICS

Laboratory Demographics

CLIA Number: 52D2300414

Facility Name: UW HEALTH WISCONSIN PSYCHIATRIC INSTITUTE & CLINICS

Facility Address:
6001 RESEARCH PARK BLVD
MADISON, WI
ZIP 53719
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Facility Phone Number: 608 263-6792

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1598295610

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	52D2300414
LAB Type	Physician Office
Facility Name	UW HEALTH WISCONSIN PSYCHIATRIC INSTITUTE & CLINICS
Street	6001 RESEARCH PARK BLVD
City	MADISON
State	WI
ZIP	53719
Phone	608 263-6792
CertificateType	4
CertificateEffectiveDate	3/11/2024
CertificateExpirationDate	3/10/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024