52D2317470 CLIA NUMBER - WISCONSIN SPINE AND PAIN - WAUKESHA

Laboratory Demographics

  • CLIA Code: 52D2317470
  • Facility Name: WISCONSIN SPINE AND PAIN - WAUKESHA
  • Facility Address: 2607 N GRANDVIEW BLVD #102
    WAUKESHA, WI
    ZIP 53188
  • Facility Phone: 920 838-6426
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL JUNG
  • NPI Number: 1538817093
  • Taxonomy: 1223G0001X - Dentist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2317470
LAB Type Physician Office
Facility Name WISCONSIN SPINE AND PAIN - WAUKESHA
Street 2607 N GRANDVIEW BLVD #102
City WAUKESHA
State WI
ZIP 53188
Phone 920 838-6426
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Physician Office
Lab Director DR. MICHAEL JUNG

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025