CLIA lab
CLIA 52D2164196: Country Villa Assisted Living II
Freedom, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D2164196 belongs to Country Villa Assisted Living II in Freedom, WI.
Certificate of Waiver, effective March 29, 2025, expires March 28, 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
- March 29, 2025
- Certificate expiration
- March 28, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- March 29, 2019
- Facility type
- Assisted living facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 3
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 52D2164196
- Lab name
- Country Villa Assisted Living II
- Address
- N3779 Country Villa Way, Freedom, WI 54913
- Phone
- (920) 422-4620
- Fax
- (920) 423-3106
Annual test volume the lab reported
- Waived tests
- 4,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Freedom, WI
Related
Questions
What is the CLIA number for Country Villa Assisted Living II in Freedom?
52D2164196, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Country Villa Assisted Living II hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D2164196 expire?
The CMS file lists March 28, 2027 as the certificate expiration date; the certificate took effect March 29, 2025.