NPIMap

Organization Active NPI

Mequon Labs Inc

  • Clinical Medical Laboratory
  • Mequon, WI
National Provider Identifier
1467612895
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MEQUON LABS INC
Practice address
10500 N Port Washington Rd
Mequon, WI 53092-5585
Phone
(262) 240-0427
Fax
(262) 240-0429
NPI assigned
Jun 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Authorized official

Name
Lawrence A Kane III, LCSW
Title
Owner
Phone
(262) 240-0427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

10500 N Port Washington Rd
Mequon, WI 53092-5585

Mailing address

10500 N Port Washington Road
Mequon, WI 53092
Phone (262) 240-0427

Other identifiers 1

IdentifierTypeStateIssuer
36204000MedicaidWI

National Provider Directory

National Provider Directory

Locations

10500 N Port Washington Rd
Mequon, WI 53092
Phone (262) 240-0427

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1467612895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10500 N PORT WASHINGTON ROAD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "53092",
            "telephone_number": "262-240-0427",
            "fax_number": "262-240-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 N PORT WASHINGTON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925585",
            "telephone_number": "262-240-0427",
            "fax_number": "262-240-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEQUON LABS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-240-0427",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36204000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.