52D2302571 CLIA NUMBER - RACINE COUNTY DETENTION CENTER

Laboratory Demographics

  • CLIA Code: 52D2302571
  • Facility Name: RACINE COUNTY DETENTION CENTER
  • Facility Address: 1717 TAYLOR AVE
    RACINE, WI
    ZIP 53403
  • Facility Phone: 262 638-6397
  • Facility Type: Other - COUNTY JUVENILE DETENTION
  • Facility Type: Waiver
  • Lab Director: SHELLY VIETS
  • NPI Number: 1326294687
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 52D2302571
LAB Type Other - COUNTY JUVENILE DETENTION
Facility Name RACINE COUNTY DETENTION CENTER
Street 1717 TAYLOR AVE
City RACINE
State WI
ZIP 53403
Phone 262 638-6397
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2024
Certificate Expiration Date 4/10/2026
Facility Type Other - COUNTY JUVENILE DETENTION
Lab Director SHELLY VIETS

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