MEDICARE: INSTANT DRAW LABORATORY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	291U00000X	Clinical Medical Laboratory
2	293D00000X	Physiological Laboratory
3	246RP1900X	Phlebotomy Technician

General Provider Information

NPI Number	:	1043142276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSTANT DRAW LABORATORY LLC

Provider Business Mailing Address
First Line	:	8531 W DOUGLAS AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53225-1917
Country	:	US
Telephone Number	:	262-595-7998
Fax Number	:

Provider Business Practice Location Address
First Line	:	8531 W DOUGLAS AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53225-1917
Country	:	US
Telephone Number	:	262-595-7998
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHLEBOTOMIST
Name	:	SIDNEY L SMITH
Credential	:
Telephone Number	:	262-595-7998

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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