CLIA lab
CLIA 52D2206122: Countryside
Ellsworth, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D2206122 belongs to Countryside in Ellsworth, WI.
Certificate of Waiver, effective December 17, 2024, expires December 16, 2026.
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
- December 17, 2024
- Certificate expiration
- December 16, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 17, 2020
- 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
- 52D2206122
- Lab name
- Countryside
- Address
- N5335B 760th St, Ellsworth, WI 54011
- Phone
- (715) 273-5060
- Fax
- (715) 273-6206
Annual test volume the lab reported
- Waived tests
- 499
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Ellsworth, WI
- BrooksideCertificate of Waiver, Assisted living facility52D2206116
- Cedar HouseCertificate of Waiver, Assisted living facility52D2200376
- Ellsworth Health ServicesCertificate of Waiver, Skilled nursing or nursing facility52D0670506
- Maple ViewCertificate of Waiver, Assisted living facility52D2206112
- Mayo Clinic Health System EllsworthCertificate of Waiver, Physician office52D0394239
- ParksideCertificate of Waiver, Assisted living facility52D2200410
- Pierce County Jail Health ServicesCertificate of Waiver, Other52D2225272
- Pierce County Public HealthCertificate for Provider-Performed Microscopy Procedures, Public health laboratory52D0662015
- Preferred Senior LivingCertificate of Waiver, Assisted living facility52D2084859
- Summit ViewCertificate of Waiver, Assisted living facility52D2206075
Related
Questions
What is the CLIA number for Countryside in Ellsworth?
52D2206122, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Countryside hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D2206122 expire?
The CMS file lists December 16, 2026 as the certificate expiration date; the certificate took effect December 17, 2024.