Organization
ST CLOUD PATHOLOGISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA RENNER (BUSINESS MANAGER)
(320) 761-1011
Entity
Organization
Contact information
Practice address
1406 6TH AVE N, ST CLOUD, MN 56303-1901
(320) 251-2700
(320) 255-5838
Mailing address
PO BOX 7848, SAINT CLOUD, MN 56302-7848
(320) 251-2700
(320) 255-5838
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
655013400
—
MN
Enumeration date
02/02/2006
Last updated
10/26/2020
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