Mequon Labs Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEQUON LABS INC

Practice address

1415 Donges Bay Road
Mequon, WI 53092-5528

Phone

(262) 240-5443

Fax

(262) 240-0755

NPI assigned

Nov 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mozafar Saleki, MS MT

Title

Laboratory Director

Phone

(262) 240-5443

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073686846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 DONGES BAY ROAD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925528",
            "telephone_number": "262-240-5443",
            "fax_number": "262-240-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 DONGES BAY ROAD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925528",
            "telephone_number": "262-240-5443",
            "fax_number": "262-240-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEQUON LABS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SALEKI",
        "authorized_official_first_name": "MOZAFAR",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "262-240-5443",
        "authorized_official_credential": "MS MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Mequon, WI
• Providers in Mequon, WI by specialty
• Clinical Medical Laboratory in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.