Organization
STATE UNIVERSITY OF IOWA
Active
Parent organization
STATE UNIVERSITY OF IOWA
Other names
Pathology Referral Testing Billing Dept
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE UNIVERSITY OF IOWA
Authorized official
MICHAEL B COHEN MD (HEAD)
(319) 384-9609
Entity
Organization
Contact information
Practice address
200 HAWKINS DR, C660 GH, IOWA CITY, IA 52242-1009
(319) 384-9647
(319) 384-5184
Mailing address
200 HAWKINS DR, C660 GH, IOWA CITY, IA 52242-1009
(319) 384-9647
(319) 384-5184
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
16D0664625
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0291393
—
IA
01
—
33898
WELLMARK BC/BS
IA
Enumeration date
08/09/2005
Last updated
05/02/2016
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