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University of Wisconsin System Non Payroll

Organization Active NPI Clinical Medical Laboratory · Madison, WI

NPI 1669458386 · NPPES record last updated Dec 4, 2024

Key facts

NPI
1669458386
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
License
52D0669558 (WI)
Legal business name
UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
Practice address
465 Henry Mall
Madison, WI 53706-1378
Phone
(608) 262-3911
Fax
(608) 262-3257
NPI assigned
Dec 15, 2005
Organization subpart
No

Authorized official

Name
Errin Rider, PH.D.
Title
Associate Director of Clinical Test
Phone
(608) 890-0288

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 111

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

View all 111

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0669558Wisconsin State Laboratory of Hygiene
465 Henry Mall, Madison, WI 53706		AccreditationJan 2, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100514000012 WI Part B Supplier - Independent Clinical Laboratory 9133024888 Practice locations: Madison, WI

National Provider Directory

Tax ID family
Uw Systems (25 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 52D0669558 WI Yes
Clinical Medical Laboratory 291U00000X 52D0661989 WI

Addresses

Primary practice location

465 Henry Mall
Madison, WI 53706-1378

Mailing address

465 Henry Mall
Madison, WI 53706-1378
Phone (608) 262-3911

Other identifiers

IdentifierTypeStateIssuer
32908700MedicaidWI

Other names

  • Board of Regents University of Wis System WI State Laboratory of Hygie Doing business as

Other providers in Madison, WI

All providers in Madison, WI · Clinical Medical Laboratory in Wisconsin

Sources for this page

Verify at the official NPI Registry.