CLIA lab
CLIA 52D2170876: Independent Physicians of Wisconsin, LLC
Kenosha, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D2170876 belongs to Independent Physicians of Wisconsin, LLC in Kenosha, WI.
Certificate of Waiver, effective August 21, 2025, expires August 20, 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
- August 21, 2025
- Certificate expiration
- August 20, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 21, 2019
- Facility type
- Physician office
- 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
- 52D2170876
- Lab name
- Independent Physicians of Wisconsin, LLC
- Address
- 6125 Green Bay Rd, Suite 600, Kenosha, WI 53142
- Phone
- (877) 287-1962
- Fax
- (855) 312-3698
Annual test volume the lab reported
- Waived tests
- 800
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Aurora Health CareCertificate of Waiver, Physician office52D2322713
- Aurora Health Care Metro Inc - Kenosha SouthCertificate of Compliance, Ancillary test site52D0979989
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- Aurora Health CenterCertificate for Provider-Performed Microscopy Procedures, Physician office52D2148960
Related
Questions
What is the CLIA number for Independent Physicians of Wisconsin, LLC in Kenosha?
52D2170876, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Independent Physicians of Wisconsin, LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D2170876 expire?
The CMS file lists August 20, 2027 as the certificate expiration date; the certificate took effect August 21, 2025.