CLIA lab

CLIA 52D2030984: Waterford at Plymouth I, the

Plymouth, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 52D2030984 belongs to Waterford at Plymouth I, 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
52D2030984
Lab name
Waterford at Plymouth I, the
Address
2581 Valley Rd, Plymouth, WI 53073
Phone
(920) 892-8324
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.

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Related

Questions

What is the CLIA number for Waterford at Plymouth I, the in Plymouth?

52D2030984, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Waterford at Plymouth I, the hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 52D2030984 expire?

The CMS file lists October 9, 2027 as the certificate expiration date; the certificate took effect October 10, 2025.

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