Organization
HEALTHPATH DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE HELFGOTT KRISZTAL J.D. (CORPORATE COUNSEL)
(414) 871-9111
Entity
Organization
Contact information
Practice address
6040 W LISBON AVE STE 101, MILWAUKEE, WI 53210-2116
(414) 871-9111
Mailing address
6040 W LISBON AVE STE 101, MILWAUKEE, WI 53210-2116
(414) 871-9111
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
52D2046228
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52D2046228
CLIA LABORATORY ID NUMBER
WI
Enumeration date
07/26/2012
Last updated
09/20/2012
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