52D2330272 CLIA NUMBER - ST CROIX HOSPICE

Laboratory Demographics

  • CLIA Code: 52D2330272
  • Facility Name: ST CROIX HOSPICE
  • Facility Address: 625 WHITETAIL BLVD, SUITE 101
    RIVER FALLS, WI
    ZIP 54022
  • Facility Phone: 715 598-2628
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JERNEY PAUL
  • NPI Number: 1760965024
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 52D2330272
LAB Type Hospice
Facility Name ST CROIX HOSPICE
Street 625 WHITETAIL BLVD, SUITE 101
City RIVER FALLS
State WI
ZIP 54022
Phone 715 598-2628
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Hospice
Lab Director JERNEY PAUL

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