CLIA lab
CLIA 52D2241947: Sam 25 Community Health Clinic
Shawano, WI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 52D2241947 belongs to Sam 25 Community Health Clinic in Shawano, WI.
Certificate of Waiver, effective November 3, 2025, expires November 2, 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
- November 3, 2025
- Certificate expiration
- November 2, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 3, 2021
- Facility type
- Community clinic
- 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
- 52D2241947
- Lab name
- Sam 25 Community Health Clinic
- Address
- 105 E Richmond St, Shawano, WI 54166
- Phone
- (715) 851-7252
- Fax
- (715) 309-5629
Annual test volume the lab reported
- Waived tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Cottages on Golden Pond, theCertificate of Waiver, Assisted living facility52D2048512
- Evergreen Health ServicesCertificate of Waiver, Skilled nursing or nursing facility52D0394594
- Forefront Dermatology, SCCertificate for Provider-Performed Microscopy Procedures, Physician office52D2023671
- Fresenius Medical Care ShawanoCertificate of Waiver, End stage renal disease dialysis facility52D2013009
- Prevea Shawano Health Center - LabCertificate of Accreditation, Physician office52D2145550
- Shawano Ambulance ServiceCertificate of Waiver, Ambulance52D1059007
- Shawano County JailCertificate of Waiver, Other52D2079879
Related
Questions
What is the CLIA number for Sam 25 Community Health Clinic in Shawano?
52D2241947, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Sam 25 Community Health Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 52D2241947 expire?
The CMS file lists November 2, 2027 as the certificate expiration date; the certificate took effect November 3, 2025.