Organization
MORELAND MEDICAL CENTER
Active
Other names
Moreland Medical Center Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN EDWARD STAGER (DIRECTOR OF ANCILLARY SERVICES)
(262) 452-8020
Entity
Organization
Contact information
Practice address
1111 DELAFIELD ST, SUITE 301, WAUKESHA, WI 53188-3417
(262) 542-8020
(262) 650-4398
Mailing address
1111 DELAFIELD ST, SUITE 301, WAUKESHA, WI 53188-3417
(262) 542-8020
(262) 650-4398
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32908800
—
WI
Enumeration date
10/06/2005
Last updated
03/15/2010
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