52D2315182 CLIA NUMBER - PREMIER PEDIATRICS LTD

Laboratory Demographics

  • CLIA Code: 52D2315182
  • Facility Name: PREMIER PEDIATRICS LTD
  • Facility Address: 6121 GREEN BAY RD - SUITE 150
    KENOSHA, WI
    ZIP 53142
  • Facility Phone: 262 553-6400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JASON R. FRIEDLANDER
  • NPI Number: 1144053232
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 52D2315182
LAB Type Physician Office
Facility Name PREMIER PEDIATRICS LTD
Street 6121 GREEN BAY RD - SUITE 150
City KENOSHA
State WI
ZIP 53142
Phone 262 553-6400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Physician Office
Lab Director DR. JASON R. FRIEDLANDER

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