CLIA lab
CLIA 52D2196191: Wautoma Hometown Pharmacy LLC
Wautoma, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D2196191 belongs to Wautoma Hometown Pharmacy LLC in Wautoma, WI.
Certificate of Waiver, effective October 15, 2026, expires October 14, 2028.
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 15, 2026
- Certificate expiration
- October 14, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 15, 2020
- Facility type
- Pharmacy
- 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
- 52D2196191
- Lab name
- Wautoma Hometown Pharmacy LLC
- Address
- W7810 State Road 21 73 Suite 300, Wautoma, WI 54982
- Phone
- (920) 992-6800
- Fax
- (920) 992-6801
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Aurora Health CenterCertificate for Provider-Performed Microscopy Procedures, Physician office52D1000631
- Forefront Dermatology, SCCertificate of Waiver, Physician office52D2029954
- Heartland HouseCertificate of Waiver, Assisted living facility52D1068446
- Noble Community ClinicsCertificate of Waiver, Federally qualified health center52D0398011
- Silver Lake Manor Wautoma LLC CbrfCertificate of Waiver, Assisted living facility52D2004137
- Thedacare Physicians - Wautoma Hwy 22 NorthCertificate for Provider-Performed Microscopy Procedures, Physician office52D0397741
- Waushara County Emergency ServicesCertificate of Waiver, Ambulance52D0930739
- Waushara County HealthCertificate of Waiver, Public health laboratory52D0712972
- Waushara County JailCertificate of Waiver, Other52D2264111
Related
Questions
What is the CLIA number for Wautoma Hometown Pharmacy LLC in Wautoma?
52D2196191, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Wautoma Hometown Pharmacy LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D2196191 expire?
The CMS file lists October 14, 2028 as the certificate expiration date; the certificate took effect October 15, 2026.