52D2305111 CLIA NUMBER - PROLABORATORY SERVICES

Laboratory Demographics

  • CLIA Code: 52D2305111
  • Facility Name: PROLABORATORY SERVICES
  • Facility Address: 1109 W MACARTHUR AVE UNIT C
    EAU CLAIRE, WI
    ZIP 54701
  • Facility Phone: 715 514-1443
  • Facility Type: Other - POC/DRUG & ALCOHOL TESTIN
  • Facility Type: Waiver
  • Lab Director: SELETA L. VANG
  • NPI Number: 1477303246
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 52D2305111
LAB Type Other - POC/DRUG & ALCOHOL TESTIN
Facility Name PROLABORATORY SERVICES
Street 1109 W MACARTHUR AVE UNIT C
City EAU CLAIRE
State WI
ZIP 54701
Phone 715 514-1443
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Other - POC/DRUG & ALCOHOL TESTIN
Lab Director SELETA L. VANG

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