Organization
MEQUON LABS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE A KANE III LCSW (OWNER)
(262) 240-0427
Entity
Organization
Contact information
Practice address
10500 N PORT WASHINGTON RD, MEQUON, WI 53092-5585
(262) 240-0427
(262) 240-0429
Mailing address
10500 N PORT WASHINGTON ROAD, MEQUON, WI 53092
(262) 240-0427
(262) 240-0429
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36204000
—
WI
Enumeration date
06/10/2008
Last updated
06/10/2008
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