| NPI | 1679746747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT POLENZ Administrator 715-743-3101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WI 52D0395541) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-04-16 |