Organization
NORTHREACH HEALTHCARE LLC
Active
Other names
NorthReach Lab
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE K STROOBANTS (CREDENTIALING SPECIALIST)
(920) 445-7226
Entity
Organization
Contact information
Practice address
3200 SHORE DR, UPPER LEVEL, MARINETTE, WI 54143-4202
(715) 732-8645
(715) 732-8652
Mailing address
3120 RIVERSIDE AVE, GATE B BUILDING 1, MARINETTE, WI 54143-6007
(715) 732-2075
(715) 732-2092
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
52D0394498
—
291U00000X
Clinical Medical Laboratory
52D2088280
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52D0394498
CLIA NUMBER
WI
01
—
CLIA NUMBER
52D2088280
WI
Enumeration date
01/31/2007
Last updated
04/16/2015
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