NPIMap

Organization Active NPI

University of Wisconsin System Non Payroll

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

  • Clinical Medical Laboratory
  • Madison, WI
National Provider Identifier
1669458386
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
52D0669558 Issued in WI
Legal business name
UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
Doing business as
Board of Regents University of Wis System WI State Laboratory of Hygie
Practice address
465 Henry Mall
Madison, WI 53706-1378
Phone
(608) 262-3911
Fax
(608) 262-3257
NPI assigned
Dec 15, 2005
Last updated
Dec 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

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

Specialties & licenses 2

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

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 1

IdentifierTypeStateIssuer
32908700MedicaidWI

Other names 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

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

Other NPIs with the same Medicare PAC ID 2

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0669558Wisconsin State Laboratory of Hygiene465 Henry Mall, Madison, WI 53706AccreditationJan 2, 2028

National Provider Directory

National Provider Directory
Tax ID family
Uw Systems-Wausau Fam P25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

2601 Agriculture Dr
Madison, WI 53718
Phone (608) 224-6202

465 Henry Mall
Madison, WI 53706
Phone (608) 890-1112

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1669458386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 HENRY MALL",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537061378",
            "telephone_number": "608-262-3911",
            "fax_number": "608-262-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 HENRY MALL",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537061378",
            "telephone_number": "608-262-3911",
            "fax_number": "608-262-3257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-15",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "RIDER",
        "authorized_official_first_name": "ERRIN",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR OF CLINICAL TEST",
        "authorized_official_telephone_number": "608-890-0288",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "52D0661989",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "52D0669558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32908700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Board of Regents University of Wis System WI State Laboratory of Hygie",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Board of Regents University of Wis System WI State Laboratory of Hygie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.