CLIA lab
CLIA 52D0394605: TC Fam Med Shawano
Shawano, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D0394605 belongs to TC Fam Med Shawano in Shawano, WI.
Certificate of Waiver, effective September 21, 2025, expires September 20, 2027.
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
- September 21, 2025
- Certificate expiration
- September 20, 2027
- 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
- 52D0394605
- Lab name
- TC Fam Med Shawano
- Address
- 100 County Road B, Shawano, WI 54166
- Phone
- (920) 830-5869
Annual test volume the lab reported
- Waived tests
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Aurora Health Care - ShawanoCertificate for Provider-Performed Microscopy Procedures, Physician office52D1033084
- Birch Hill Health ServicesCertificate of Waiver, Skilled nursing or nursing facility52D0671511
- Cottages Memory Care, theCertificate of Waiver, Assisted living facility52D2048514
- Cottages on Golden Pond, theCertificate of Waiver, Assisted living facility52D2048512
- Evergreen Health ServicesCertificate of Waiver, Skilled nursing or nursing facility52D0394594
- Forefront Dermatology, SCCertificate for Provider-Performed Microscopy Procedures, Physician office52D2023671
- Fresenius Medical Care ShawanoCertificate of Waiver, End stage renal disease dialysis facility52D2013009
- Prevea Shawano Health Center - LabCertificate of Accreditation, Physician office52D2145550
- Sam 25 Community Health ClinicCertificate of Waiver, Community clinic52D2241947
- Shawano Ambulance ServiceCertificate of Waiver, Ambulance52D1059007
Related
Questions
What is the CLIA number for TC Fam Med Shawano in Shawano?
52D0394605, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does TC Fam Med Shawano hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D0394605 expire?
The CMS file lists September 20, 2027 as the certificate expiration date; the certificate took effect September 21, 2025.