CLIA lab
CLIA 52D1073117: Gables on the Pond I & II
Random Lake, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D1073117 belongs to Gables on the Pond I & II in Random Lake, WI.
Certificate of Waiver, effective August 31, 2025, expires August 30, 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
- August 31, 2025
- Certificate expiration
- August 30, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 31, 2007
- Facility type
- Other
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 52D1073117
- Lab name
- Gables on the Pond I & II
- Address
- 305 S Spring St, Random Lake, WI 53075
- Phone
- (920) 994-8304
- Fax
- (920) 994-8222
Annual test volume the lab reported
- Waived tests
- 32
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Random Lake, WI
Related
Questions
What is the CLIA number for Gables on the Pond I & II in Random Lake?
52D1073117, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Gables on the Pond I & II hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D1073117 expire?
The CMS file lists August 30, 2027 as the certificate expiration date; the certificate took effect August 31, 2025.