CLIA lab
CLIA 52D2161005: Southern Lakes Endoscopy Center, LLC
Mukwonago, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D2161005 belongs to Southern Lakes Endoscopy Center, LLC in Mukwonago, WI.
Certificate of Waiver, effective January 24, 2025, expires January 23, 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
- January 24, 2025
- Certificate expiration
- January 23, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 24, 2019
- Facility type
- Ambulatory surgery center
- 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
- 52D2161005
- Lab name
- Southern Lakes Endoscopy Center, LLC
- Address
- 240 Maple Avenue Suite 2220, Mukwonago, WI 53149
- Phone
- (414) 454-0600
- Fax
- (262) 368-4015
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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Related
Questions
What is the CLIA number for Southern Lakes Endoscopy Center, LLC in Mukwonago?
52D2161005, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Southern Lakes Endoscopy Center, LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D2161005 expire?
The CMS file lists January 23, 2027 as the certificate expiration date; the certificate took effect January 24, 2025.