Organization
CONSULTANTS LABORATORY OF WISCONSIN, LLC
Active
Parent organization
CONSULTANTS LABORATORY OF WISCONSIN, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CONSULTANTS LABORATORY OF WISCONSIN, LLC
Authorized official
DEBORAH CHRISTIAN (SUPERVISOR REVENUE CYCLE PT ACCOUNT)
(920) 926-5840
Entity
Organization
Contact information
Practice address
933 NEWBURY ST, RIPON, WI 54971-1730
(920) 948-9147
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
—
52D0397949
CLIAA
WI
Enumeration date
05/11/2011
Last updated
12/16/2022
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