Organization
MDS LAB LLC
Active
Other names
MD'S LAB
Organization subpart
No
Provider details
NPI number
Authorized official
VIBHA SURANI (PRESIDENT)
(414) 336-8918
Entity
Organization
Contact information
Practice address
823 S LAYTON BLVD, MILWAUKEE, WI 53215-1225
(414) 336-8918
Mailing address
2741 W LAYTON AVE STE 201, MILWAUKEE, WI 53221-2600
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52D2250416
CLIA LIC
WI
Enumeration date
01/27/2022
Last updated
01/27/2022
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