CLIA lab
CLIA 52D2239324: Thedacare Physicians Green Lake
Green Lake, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D2239324 belongs to Thedacare Physicians Green Lake in Green Lake, WI.
Certificate of Waiver, effective October 12, 2025, expires October 11, 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
- October 12, 2025
- Certificate expiration
- October 11, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 12, 2021
- Facility type
- Physician office
- Ownership (control type)
- Private
- 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
- 52D2239324
- Lab name
- Thedacare Physicians Green Lake
- Address
- 670 Cty Hwy A, Green Lake, WI 54941
- Phone
- (920) 294-0100
- Fax
- (920) 294-0123
Annual test volume the lab reported
- Waived tests
- 600
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Green Lake, WI
- Barrett House of Green LakeCertificate of Waiver, Assisted living facility52D2059242
- Barrett House of Green Lake RcacCertificate of Waiver, Other52D1012636
- Green Lake Co Human Services-Hlth UnitCertificate of Waiver, Public health laboratory52D0663884
- Green Lake County Correctional FacilityCertificate of Waiver, Other52D2133093
Related
Questions
What is the CLIA number for Thedacare Physicians Green Lake in Green Lake?
52D2239324, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Thedacare Physicians Green Lake hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D2239324 expire?
The CMS file lists October 11, 2027 as the certificate expiration date; the certificate took effect October 12, 2025.