52D2305017 CLIA NUMBER - MADISON EAST VA CLINIC

Laboratory Demographics

  • CLIA Code: 52D2305017
  • Facility Name: MADISON EAST VA CLINIC
  • Facility Address: 4904 EASTPARK BLVD
    MADISON, WI
    ZIP 53718
  • Facility Phone: 608 256-1901
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: THOMAS RAJ
  • NPI Number: 1194992404
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2305017
LAB Type Community Clinic
Facility Name MADISON EAST VA CLINIC
Street 4904 EASTPARK BLVD
City MADISON
State WI
ZIP 53718
Phone 608 256-1901
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 5/22/2024
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director THOMAS RAJ

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