CLIA lab
CLIA 52D2030980: Waterford at Plymouth III, the
Plymouth, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D2030980 belongs to Waterford at Plymouth III, the in Plymouth, WI.
Certificate of Waiver, effective October 10, 2025, expires October 9, 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
- October 10, 2025
- Certificate expiration
- October 9, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 10, 2011
- Facility type
- Assisted living facility
- Ownership (control type)
- Proprietary
- 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
- 52D2030980
- Lab name
- Waterford at Plymouth III, the
- Address
- 2586 Valley Rd, Plymouth, WI 53073
- Phone
- (920) 892-4635
- Fax
- (920) 893-0157
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Plymouth, WI
- Advanced EyecareCertificate of Waiver, Physician office52D2249172
- Ahc Plymouth ClinicCertificate of Waiver, Physician office52D2030969
- Anovia Health PlymouthCertificate of Waiver, Community clinic52D2349148
- Plymouth Clinic LabCertificate of Waiver, Physician office52D2316375
- Plymouth Fire Dept Ambulance SquadCertificate of Waiver, Ambulance52D0989948
- Plymouth Health ServicesCertificate of Waiver, Skilled nursing or nursing facility52D1031655
- Plymouth School DistrictCertificate of Waiver, School or student health service52D2226809
- Prevea Health- Lakeland UniversityCertificate of Waiver, School or student health service52D2190573
- Prevea Plymouth Family PracticeCertificate for Provider-Performed Microscopy Procedures, Physician office52D2007277
- Rocky Knoll Health Care FacilityCertificate of Waiver, Skilled nursing or nursing facility52D0039069
Related
Questions
What is the CLIA number for Waterford at Plymouth III, the in Plymouth?
52D2030980, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Waterford at Plymouth III, the hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D2030980 expire?
The CMS file lists October 9, 2027 as the certificate expiration date; the certificate took effect October 10, 2025.