52D2307295 CLIA NUMBER - NURSEGENICS LLC

Laboratory Demographics

  • CLIA Code: 52D2307295
  • Facility Name: NURSEGENICS LLC
  • Facility Address: 2363 S 102ND ST
    WEST ALLIS, WI
    ZIP 53227
  • Facility Phone: 262 417-1195
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: AUDRYUNNA T. TATE
  • NPI Number: 1205683737
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2307295
LAB Type Mobile Laboratory
Facility Name NURSEGENICS LLC
Street 2363 S 102ND ST
City WEST ALLIS
State WI
ZIP 53227
Phone 262 417-1195
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2024
Certificate Expiration Date 7/4/2026
Facility Type Mobile Laboratory
Lab Director AUDRYUNNA T. TATE

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