Healthcare Provider Details

I. General information

NPI: 1831005537
Provider Name (Legal Business Name): KIAS LABBS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W62N217 WASHINGTON AVE
CEDARBURG WI
53012-2726
US

IV. Provider business mailing address

W62N217 WASHINGTONAVE
CEDARBURG WI
53012
US

V. Phone/Fax

Practice location:
  • Phone: 414-484-1429
  • Fax:
Mailing address:
  • Phone: 414-484-1429
  • Fax: 414-484-1429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: NOTKIA S DAVIS
Title or Position: OWNER
Credential:
Phone: 414-484-1428