Consultants Laboratory of Wisconsin, LLC
Organization Active NPI Clinical Medical Laboratory · Ripon, WI
NPI 1629360540 · NPPES record last updated Dec 16, 2022
Key facts
- NPI
- 1629360540
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- CONSULTANTS LABORATORY OF WISCONSIN, LLC
- Practice address
- 933 Newbury St
Ripon, WI 54971-1730 - Phone
- (920) 948-9147
- NPI assigned
- May 11, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- CONSULTANTS LABORATORY OF WISCONSIN, LLC
Authorized official
- Name
- Deborah Christian
- Title
- Supervisor Revenue Cycle PT Account
- Phone
- (920) 926-5840
Other NPIs on the same Medicare enrollment 14
Corporate family (same tax ID) 12
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040311001446 | WI | Part B Supplier - Independent Clinical Laboratory | 8628967205 |
19 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fond Du Lac, WI; Waupun, WI; Ripon, WI; North Fond Du Lac, WI; Mount Calvary, WI; Mayville, WI; Fox Lake, WI; Markesan, WI… |
National Provider Directory
- Tax ID family
- Consultants Laboratory
- Part of
- Consultants Laboratory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
933 Newbury St
Ripon, WI 54971-1730
Mailing address
430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-5840
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52D0397949 | Other | WI | CLIAA |
Other providers in Ripon, WI
- Amy Elizabeth Clarke
- Jennifer Ann Clausen
- Michael J. Combs
- Community Health Network Inc
- Consultants Laboratory of Wisconsin, LLC
- Cooperleaf Management Group
- Katelynn Coughlin
- Danielle M Covach
- John Dalsbo
- Jessica L Davis
All providers in Ripon, WI · Clinical Medical Laboratory in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.