CLIA lab
CLIA 52D0394375: Thedacare Physicians Black Creek
Black Creek, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D0394375 belongs to Thedacare Physicians Black Creek in Black Creek, WI.
Certificate of Waiver, effective March 30, 2026, expires March 29, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- March 30, 2026
- Certificate expiration
- March 29, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 1992
- Facility type
- Physician office
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 52D0394375
- Lab name
- Thedacare Physicians Black Creek
- Address
- 400 S Maple St, Black Creek, WI 54106
- Phone
- (920) 984-3361
- Fax
- (920) 358-1577
Annual test volume the lab reported
- Waived tests
- 450
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Black Creek, WI
Related
Questions
What is the CLIA number for Thedacare Physicians Black Creek in Black Creek?
52D0394375, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Thedacare Physicians Black Creek hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D0394375 expire?
The CMS file lists March 29, 2028 as the certificate expiration date; the certificate took effect March 30, 2026.