Organization
CONSULTANTS LABORATORY OF WISCONSIN, LLC
Active
Other names
SSM Health Laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH LYNN CHRISTIAN (SUPERVISOR, REV CYCLE PATIENT ACCTS)
(920) 926-5840
Entity
Organization
Contact information
Practice address
130 CORPORATE DR, BEAVER DAM, WI 53916-3116
(920) 926-5840
Mailing address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-5840
(920) 929-0647
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52D0394045
CLIA
WI
Enumeration date
01/25/2021
Last updated
12/16/2022
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