Organization
OMEGAQUANT
Active
Other names
Omegabiostatus
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM STEPHEN HARRIS PHD (PRESIDENT)
(605) 271-6917
Entity
Organization
Contact information
Practice address
5009 W 12TH ST, SUITE 8, SIOUX FALLS, SD 57106-3988
(605) 271-6917
Mailing address
5009 W 12TH ST, SUITE 8, SIOUX FALLS, SD 57106-3988
(605) 271-6917
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
DL019088
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43D1105229
CLIA
SD
Enumeration date
05/02/2016
Last updated
05/02/2016
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