Organization
WISCONSIN DIAGNOSTIC LABORATORIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN HERBNER (CFO)
(414) 805-7793
Entity
Organization
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-7699
Mailing address
PO BOX 78055, MILWAUKEE, WI 53278-8055
(414) 805-7680
(414) 805-7514
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32921300
—
WI
Enumeration date
07/22/2005
Last updated
11/19/2024
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