Healthcare Provider Details

I. General information

NPI: 1952384216
Provider Name (Legal Business Name): DUNES MEDICAL LABORATORIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 TOWER RD SUITE 220
DAKOTA DUNES SD
57049
US

IV. Provider business mailing address

PO BOX 1463
SIOUX CITY IA
51102-1463
US

V. Phone/Fax

Practice location:
  • Phone: 605-232-4270
  • Fax:
Mailing address:
  • Phone: 712-279-2263
  • 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: JESICA HANSON
Title or Position: VP FINANCE
Credential:
Phone: 712-279-5850