52D2308466 CLIA NUMBER - PREMIER SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 52D2308466
  • Facility Name: PREMIER SURGERY CENTER LLC
  • Facility Address: 200 DIVISION STREET
    STEVENS POINT, WI
    ZIP 54481
  • Facility Phone: 715 544-1775
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. WILLIAM S. BODEMER
  • NPI Number: 1497599609
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2308466
LAB Type Ambulatory Surgery Center
Facility Name PREMIER SURGERY CENTER LLC
Street 200 DIVISION STREET
City STEVENS POINT
State WI
ZIP 54481
Phone 715 544-1775
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2024
Certificate Expiration Date 7/29/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. WILLIAM S. BODEMER

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