Healthcare Provider Details

I. General information

NPI: 1033982129
Provider Name (Legal Business Name): MAYO COLLABORATIVE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 1ST ST SW
ROCHESTER MN
55905-0001
US

IV. Provider business mailing address

PO BOX 4100
ROCHESTER MN
55903-4100
US

V. Phone/Fax

Practice location:
  • Phone: 800-447-6424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DENNIS EUGENE DAHLEN
Title or Position: CFO
Credential:
Phone: 507-266-4416