| NPI | 1194048256 |
|---|---|
| Doing Business As | ST NICHOLAS HOSPITAL OUTPATIENT LAB |
| Entity Type | Organization |
| Authorized Contact | JUSTIN SELLE President/CEO 920-459-4798 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2021-12-27 |