CLIA lab
CLIA 52D1090480: Ksms Our House, LLC Portage Rcac
Portage, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D1090480 belongs to Ksms Our House, LLC Portage Rcac in Portage, WI.
Certificate of Waiver, effective October 13, 2026, expires October 12, 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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- October 13, 2026
- Certificate expiration
- October 12, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 13, 2008
- Facility type
- Assisted living facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 21
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 52D1090480
- Lab name
- Ksms Our House, LLC Portage Rcac
- Address
- 215 Northridge Dr, Portage, WI 53901
- Phone
- (317) 280-8455
- Fax
- (317) 875-4051
Annual test volume the lab reported
- Waived tests
- 200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Portage, WI
- Aspirus Divine Savior ClinicsCertificate of Waiver, Rural health clinic52D0879528
- Aspirus Divine Savior Hospital & ClinicsCertificate of Accreditation, Hospital52D0662006
- Columbia County Division of HealthCertificate of Waiver, Public health laboratory52D0669954
- Columbia County JailCertificate of Waiver, Other52D1077279
- Community Service Associates, SCCertificate of Waiver, Physician office52D2044509
- Hamilton Park Place Assisted Living FacilityCertificate of Waiver, Assisted living facility52D2206718
- Heritage House of PortageCertificate of Waiver, Assisted living facility52D1070390
- Klarcare, LLCCertificate of Waiver, Physician office52D2265465
- Ksms Our House, LLC Portage Assisted CareCertificate of Waiver, Assisted living facility52D1017759
- Milliken - Portage Health CenterCertificate of Waiver, Other52D2324541
Related
Questions
What is the CLIA number for Ksms Our House, LLC Portage Rcac in Portage?
52D1090480, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Ksms Our House, LLC Portage Rcac hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D1090480 expire?
The CMS file lists October 12, 2028 as the certificate expiration date; the certificate took effect October 13, 2026.