| NPI | 1144533084 |
|---|---|
| Doing Business As | BEAVER DAM REFERENCE LABORATORY |
| Entity Type | Organization |
| Authorized Contact | JOSHUA PIERCE President 888-754-0451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WI 53d0662012) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2010-07-21 |