| NPI | 1558896498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN HANSON Vice President 414-600-1020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WI 52D2127517) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2020-09-11 |